use of SGLT-2 inhibitors in T2DM

(GLIFLOZINS)

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 Introduction
• SGLT2 inhibitors are a class of medications
used to treat type 2 diabetes.
• They’re also called sodium-glucose transport
protein 2 inhibitors or gliflozins.
• Gliflozens act on the kidney and induce
glucouresis.

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 Why we select GliflOZENS?
• The have unique mechanism of action
because they promoting the lose of glucose in
urine without altering the secretion and
sensitivity of insulin.
• These drugs reduce the weight of diabetic
patient, so also called weight losing oral
antidiabetic drugs or oral hypoglycemic
agent.

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 SGLT:Sodium Glucose linked
Transporter
• SGLT-2: Low Affinity/High capacity
• Present in S1 of proximal convulated tubules
• Responsible for majority of renal glucose
reabsorption(90%)
• SGLT-1:High Affinity/Low capacity
• Present in S3 of proximal convulated tubules
• Responsible for small portion of renal glucose
reabsorption(10%)
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Ative(SGLT2) and passive (GlUT2) glucose
transport in a renal PCT

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 Renal Threshold for Glu Excretion
• When the blood glucose level exceeds about
160–180 mg/dL (8.9-10 mmol/L), the proximal
tubule becomes overwhelmed and begins to
excrete glucose in the urine. This point is
called the renal threshold for glucose (RTG).

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 GLIFLOZENS:Mechanism of action
Inhibition of glucose reabsorption in
the PCT

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 HOW DO SGLT2 INHIBITORS WORK?

• SGLT2 inhibitors work by preventing the kidneys from

reabsorbing glucose back into the blood.
• This allows the kidneys to lower blood glucose levels
and the excess glucose in the blood is removed from
the body via urine called glucouresis.
• SGLT2 inhibitors block these proteins which means less
glucose gets reabsorbed back into the blood and gets
passed out of the body via the urine.
• .

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 Positive Effects
• Better glycemic control
• Reduction in weight
• Less risk of hypoglycemia
• Reduce plasma glucose level
• Reduce renal threshhold

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 Adverse Effects
• Genital yeast infections in men and women
• Urinary tract infections (UTIs)
• Dehydration
• Hypotension (low blood pressure)
• Ketoacidosis

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 Future perspective
• Synthesis SGLT-2 and SGLT-1 inhibitors to
inhibit reabsorption of sugar in type 2
diabetes.

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• 10. References
http://diabetes.diabetesjournals.org/content/61/9/2199.full
http://www.medscape.com/viewarticle/760248
http://www.diabetesincontrol.com/articles/91-/14495-sglt2-inhibitors-a-
new http://spectrum.diabetesjournals.org/content/22/2/92.full.pdf
http://www.micromedexsolutions.com
http://www.diabetes.co.uk/diabetes-medication/sglt2-inhibitors.html
http://
www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm345848.
htm http://
www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm3808
29.htm
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/uc
m407637.htm?
source=govdelivery&utm_medium=email&utm_source=govdelivery
•

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