SGLT2 Inhibitors: Physiology and Pharmacology.

Q: One major risk of  Sodium-glucose cotransporter 2 (SGLT2) inhibitors is hypoglycemia.

A) True

B) False

Answer: B

SGLT2 acts at the kidney's proximal tubules, promoting the excretion of the filtered glucose load and causing osmotic diuresis. Consequently, the filtered glucose load limits its ability to lower blood glucose and glycated hemoglobin (A1C). This also means that SGLT2 inhibitors' actions are lower if plasma glucose levels are low, and they do not usually cause hypoglycemia.

One added advantage of SGLT2 inhibitors is their ability to modestly decrease blood pressure and weight.

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References:

1. Clar C, Gill JA, Court R, Waugh N. Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. BMJ Open 2012; 2.

2. Wright EM. SGLT2 Inhibitors: Physiology and Pharmacology. Kidney360. 2021 Sep 17;2(12):2027-2037. doi: 10.34067/KID.0002772021. PMID: 35419546; PMCID: PMC8986039.