SGLT2 – Who? New Diabetes Drug Has Doctors Hopeful

A new study in the Journal of the American Society of Nephrology (JASN) has the medical community excited about a new type of diabetes drug.

The drug, canagliflozin, works to inhibit the sodium-glucose cotransporter 2 (SGLT2), a protein in the body tasked with reabsorbing glucose into the kidneys. According to the study, the drug slows the decline in kidney function – a huge step forward for the treatment of diabetes.

A Four-Year Study

Hiddo J.L. Heerspink , PhD, a professor at the University Medical Center Groningen in the Netherlands led the team that analyzed the effects of canagliflozin from 2009 to 2013. Their subjects, 1,450 in total, were all diagnosed with type 2 diabetes and were currently taking metformin.

After randomized assignment, the subjects began taking either 100mg or 300mg of either canagliflozin or another drug, glimepiride. Heerspink and his team then evaluated changes in albuminuria and estimated glomerular filtration rate (eGFR), both of which are measures of kidney function.

At the end of the trial period, 46 of the patients taking glimepiride had experienced a 30 percent decrease in their eGFR. By contrast, only 32 patients taking canagliflozin reached that high a number. Additionally, those taking canagliflozin had better HbA1c and blood pressure than the other group on average.

New Treatment Possibilities

When asked about the prospects of canagliflozin, Dr. Heerspink said, “Our results are especially important since many patients with diabetes are at risk of progressive kidney function loss, and canagliflozin may offer a new and improved therapeutic opportunity for these patients.”

Heerspink's optimism was matched in an accompanying report from Ian de Boer, MD, and Steven Kahn, MD, ChB of the University of Washington in Seattle. “The apparent renal and CV benefits of SGLT2 inhibitors will encourage primary care physicians and endocrinologists to use these agents more frequently in the care of patients with type 2 diabetes,” they wrote, though they were quick to note that “adverse effects, costs, alternative agents and individual patient characteristics must also be taken into account.”