Renal glukosehomeostase og hyperglykemi ved type 2 diabetes mellitus, og terapeutiske muligheter ved SGLT2-hemmere
Abstract
Background: The persistent hyperglycaemia in patients with type 2 diabetes mellitus is strongly associated with microvascular and macrovascular complications.There are many hypoglycaemic agents available, with SGLT2-inihibtors representing a novel mechanism for treating hyperglycaemia in patients with type 2 diabetes mellitus.Objective: The objective of this study is to describe the role of the kidney in glucose homeostasis, changes in the kidney in patients with type 2 diabetes mellitus and to describe the mechanism of action of the SGLT2-inhibitors.Furthermore, the efficacy and safety of the drug will be assessed.Method: This study is a literature review based upon a non-systematic search in Ovid MEDLINE and PubMed.Reference lists of relevant articles were examined.Results: The kidneys play a substantial role in glucose homeostasis, filtrating approximately 180 grams of glucose every day.Physiologically, almost all glucose is reabsorbed.In the diabetic kidney, the capacity of reabsorption of glucose is increased.The SGLT2-inhibitors will inhibit some of the kidneys capacity of glucose reabsorption, with glycosuria and natriuresis, and reduced average plasma glucose concentration and HbA1c as a result.There is consistent evidence in the literature that SGLT2-inhibitors reduce HbA1c, and that it has a favourable effect on blood pressure and weight.A recent study has also shown that empagliflozin reduce the rates of death from cardiovascular causes in type 2 diabetes patients…
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