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What Are SGLT2 Inhibitors?

Medically Reviewed by Michael Dansinger, MD on January 23, 2020

If you have type 2 diabetes and you've already tried other treatments, your doctor may suggest you take medications called SGLT2 inhibitors. They work by keeping blood sugar from getting absorbed back into your kidneys.

The goal in managing your type 2 diabetes is to make a hormone called insulin more available in your body to keep your blood sugar at a healthy level. Treatments can do that in a number of ways.

The most straightforward treatment is to get a shot of insulin to raise the amount that's in your body. You may also take drugs that trigger your body to release more insulin. Other medications make your body more sensitive to insulin or slow down how fast carbohydrates get absorbed into your bloodstream.

SGLT2 inhibitors work in a different way to lower your blood sugar. They curb the action of proteins called "sodium-glucose cotransporter 2" that help your kidneys reabsorb glucose (sugar) from your blood. After you take SGLT2 inhibitors, less of your blood sugar ends up in your kidneys and more of it leaves your body in your urine.

Who Should Take an SGLT2 Inhibitor?

Your doctor might suggest you try one of these kinds of SGLT2 inhibitors:

These drugs are pills that you generally take once a day before your first meal.

Before you try an SGLT2 inhibitor, your doctor will likely suggest you make changes in your lifestyle -- like diet and exercise -- as well as take a medication such as metformin.

Because SGLT2 inhibitors are a newer medication, there isn't a lot of information about their long-term safety. And they're only able to lower blood sugar by a small amount, compared with other medications.

Your doctor might consider an SGLT2 inhibitor if:

  • You already take several medications and your blood sugar is still not well-controlled
  • There's a medical reason you can't take other diabetes medications
  • You're at risk for getting dangerously low blood sugar

The drugs can be an option if you're uncomfortable with giving yourself insulin shots. Your doctor might also suggest them if you need to lose weight or lower your blood pressure.

Who Shouldn't Take an SGLT2 Inhibitor?

The FDA hasn't approved these medications to treat type 1 diabetes. They're not recommended for anyone who has had diabetic ketoacidosis, a serious complication of diabetes.

SGLT2 inhibitors also aren't that helpful for someone who already has severe kidney disease.

What Are the Side Effects?

These medications may make you:

  • Pee more often
  • More likely to get yeast or urinary tract infections
  • Have blood pressure that is too low
  • Lose bone density
  • Be more likely to get fractures
  • Get dehydrated

The most serious side effect of SGLT2 inhibitors is a greater chance that you could get diabetic ketoacidosis, a condition that happens when your body makes too many acids called ketones.

WebMD Medical Reference

Sources

SOURCES:

Current Opinion in Endocrinology, Diabetes and Obesity: "An Update on SGLT2 Inhibitors for the Treatment of Diabetes Mellitus."

UpToDate: "Sodium-glucose co-transporter 2 inhibitors for the treatment of hyperglycemia in type 2 diabetes mellitus."

The Johns Hopkins Patient Guide to Diabetes: "SGLT2 Inhibitors."

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