title: Place of sodium-glucose cotransporter-2 inhibitors in East Asian subjects with type 2 diabetes mellitus: Insights into the management of Asian phenotype.
abstract: The burden of type 2 diabetes (T2DM) in East Asia is alarming. Rapid modernization and urbanization have led to major lifestyle changes and a tremendous increase in the prevalence of obesity, metabolic syndrome, and diabetes mellitus. The development of T2DM at a younger age, with lower body mass index, higher visceral adiposity, and more significant pancreatic beta-cell dysfunction compared to Caucasians are factors responsible for the increased prevalence of T2DM in East Asians. Sodium-glucose Cotransporter-2 (SGLT2) inhibitors (canagliflozin, dapaglifozin, empagliflozin, etc.) reduce renal glucose reabsorption, leading to favorable effects on glycemic, blood pressure, and weight control. The insulin-independent mechanism enables their use as monotherapy or combination therapy with insulin and other oral antidiabetic agents. The role of SGLT2 inhibitors in the management of T2DM among East Asians is an interesting area of research, given that East Asians have been proven to be uniquely different from Caucasians. This review provides comprehensive coverage of the available literature not only on the efficacy and safety, but also on the recent cardiovascular and renal outcomes of SGLT2 inhibitors, focusing among East Asians.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: leelinglimll@gmail.com.
authors.forename: Lee Ling
authors.initials: LL
authors.lastname: Lim
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Alexander Tong Boon
authors.initials: AT
authors.lastname: Tan
authors.affiliation: Medical Department, AstraZeneca, Malaysia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Moses
authors.affiliation: Medical Department, AstraZeneca, Malaysia.
authors.forename: Viraj
authors.initials: V
authors.lastname: Rajadhyaksha
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Siew Pheng
authors.initials: SP
authors.lastname: Chan
mesh_terms: D044466:Asian People; D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000627:therapeutic use; D000068896:Canagliflozin / Q000009:adverse effects / Q000627:therapeutic use; D048909:Diabetes Complications / Q000208:ethnology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology / Q000378:metabolism; D019317:Evidence-Based Medicine; D005960:Glucosides / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000208:ethnology; D049990:Membrane Transport Modulators / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D015203:Reproducibility of Results; D051297:Sodium-Glucose Transporter 2 / Q000378:metabolism; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; D049990:Membrane Transport Modulators; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D000068896:Canagliflozin; C529054:dapagliflozin; C570240:empagliflozin
keywords: Cardiovascular outcome; East Asians; Renoprotection; SGLT2 inhibitors; Type 2 diabetes; Visceral adiposity