The most recent class of diabetes medications to be approved by the Food and Drug Administration (FDA) is called Sodium Glucose Co-Transporter 2 Inhibitors, also known as SGLT2 inhibitors. SGLT2 inhibitors work in the kidneys by preventing glucose (sugar) from being reabsorbed into the blood stream. Instead, the sugar is eliminated in urine. By eliminating sugar this way, you lower your blood sugar levels and your A1C levels. There are now three SGLT2 inhibitors available in the United States, and they arecanagliflozin (Invokana), empagliflozin (Jardiance), and dapagliflozin (Farxiga). Each of these medications are also available as a combination product mixed with other diabetes medications.
SGLT2 inhibitors are currently approved for use in patients with type 2 diabetes. They are taken once a day in the morning. These medications may lower your blood pressure; so your blood pressure should be monitored. Sometimes the doses of your blood pressure medications can be decreased.When you urinate out sugar you are losing calories, which can lead to some weight loss. Because you may urinate more frequently when taking this drug, especially when first taking it, make sure you stay well hydrated.
Like all medications, SGLT2 inhibitors can cause some side effects. The most commonly reported in both men and women are urinary tract infections (UTI), genital fungal infections (yeast infection), and increased urination. If any of these happen, they are usually mild, easily treated, and do not reoccur. Rare side effects are diabetic ketoacidosis (DKA) and kidney infections.These medications have been prescribed world-wide to over 5 million people and the incidence of these side effects is very rare. For example, as of May 2015 there have been 92 total cases of DKA and kidney infections reported to the FDA. When considering an SGLT2 inhibitor it is important to keep these things in perspective. When used properly, these medications are safe and effective. These drugs are not toxic to your kidneys but you have to have good kidney function for them to work.
SGLT2 inhibitors are to be used along with diet and exercise in patients with type 2 diabetes. They are not FDA indicated for patients with type 1 diabetes, diabetic ketoacidosis, severe kidney problems, on dialysis, or are allergic to these medications. Your health care provider will determine if you are a good candidate for SGLT2 inhibitors. If started on one of these medications, tell your doctor if your experience any signs or symptoms of an allergic reaction such as hives or rash, signs or symptoms of a UTI such as blood in the urine or painful urination, signs or symptoms of DKA such as confusion, increased heartbeat, or vomiting.
This Article is Brought to you By Our Guest Staff Writers:
Thomas Ditch, PharmD Candidate 2016, MCPHS University
Damian Bialonczyk, PharmD, MBA Fellow, MCPHS University
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP Professor of Pharmacy Practice, MCPHS University
Clinical Pharmacist, Well Life Medical, Peabody