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薬理と治療
- Author: 綿田裕孝1
Abstract
Na+/glucose co-transporter 2(SGLT-2)inhibitors represent a new strategy in the treatment of diabetes. These drugs inhibit glucose reabsorption from renal tubules, thereby promoting urinary glucose excretion and decreasing plasma glucose levels. Furthermore, the effect to induce glycosuria is dependent on the plasma glucose level, which may be associated with a low risk of hypoglycemia. This unique mechanism of action is independent of pancreatic β-cell function. Thus, they have the potential to be used as combination therapy with other oralanti-diabetic drugs. Animal studies and clinical trials have revealed that, by causing glycosuria, SGLT-2 inhibitors not only reduce plasma glucose levels, but also cause weight losses, and improve insulin resistance or insulin secreting capacity. SGLT-2 inhibitors may benefit the diabetic state by decreasing glucotoxicity and visceral fat accumulation. To understand the characteristics of SGLT-2 inhibitors, this article reviews the role of kidney or SGLTs in glucose homeostasis, and benefit and risk of these drugs based on previous reports.
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