Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Diabetic Nephropathy: A Review of Clinical Effectiveness
Abstract
Diabetes mellitus or diabetes is a chronic condition and affects 8.2% or 382 million individuals world-wide. According to data from 2013–2014, it was estimated that in Canada the prevalence of diagnosed diabetes was 8.7% in men and 7.6% in women. Type 2 diabetes (T2D) is the most prevalent form of diabetes, and it constitutes 90% of the individuals diagnosed with diabetes. In T2D, the glycemic control is impaired. It occurs when the pancreas is unable to produce enough insulin, or when the body cannot properly use the insulin produced.Individuals with T2D are at an increased risk of developing diabetic kidney disease and it is the leading cause of end stage renal disease., Approximately 40% pf patients with T2D develop chronic kidney disease (CKD) during their lifetime., CKD is defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 for three months or longer., The kidney plays an important role in ensuring glucose homeostasis, gluconeogenesis, and the reabsorption of filtered glucose in the proximal tubules. The sodium glucose cotransporter 2 (SGLT2) present in the proximal tubule is responsible for the glucose reabsorption.It may be a challenge to adequately manage glycemic control in patients with T2D and CKD, due to both patient and medication issues. Treatment options for managing T2D include injectable medications such as insulin and glucagon-like peptide-1 receptor agonists as well as oral pharmacological agents such as metformin, thiazolidinediones,…
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