The first of a new class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitorscanagliflozin (Invokana)was approved by the U.S. Food and Drug Administration (FDA) in March 2013 to treat type 2 diabetes in adults. This medication can improve fasting blood sugar levels and hemoglobin A1c levels - which measure blood glucose control.
Other SGLT2 inhibitors include dapaglifozin (Farxiga; approved in January 2014) and empagliflozin (Jardiance; approved in August 2014). These medications may be used with diet and exercise alone, or in combination with other diabetes therapies like metformin, sulfonylurea, pioglitazone and insulin to improve glycemic control in adults with type 2 diabetes. SGLT2 inhibitors can increase the risk for bladder cancer and may cause dehydration and impaired kidney function.
Sodium-glucose co-transporter 2 inhibitors help improve glucose control in a number of ways. They block the reabsorption of glucose by the kidneys, increase glucose excretion, and lower blood sugar levels. Following approval of this new type 2 diabetes medication, the FDA is requiring post-marketing studies to evaluate the potential risk for:
- Cardiovascular side effects
- Malignancies (cancer)
- Severe pancreatitis (inflammation of the pancreas)
- Severe hypersensitivity reactions (allergic reactions)
- Photosensitivity reactions (increased sensitivity to light)
- Liver abnormalities
- Adverse effects on bone health
- Pregnancy complications
Additional studies will be performed to determine if SGLT2 inhibitors are safe and effective for use in children under the age of 18.
They should not be used in people who have type 1 diabetes, those with diabetes type 2 who have diabetic ketoacidosis (increased ketones in blood or urine), severe kidney damage or end stage kidney disease, or patients who are undergoing dialysis.
Because these drugs act as diuretics, they may cause dizziness or fainting - especially upon standing - caused by a sudden drop in blood pressure. This is more common in older adults and during the first three months of treatment. Common side effects include increased urination, vaginal yeast infections and urinary tract infections (UTI).
Your health care provider may monitor blood pressure, potassium levels and kidney function during treatment. If you're taking insulin, a lower dose may be necessary to reduce your risk for hypoglycemia (low blood sugar). This medication has not been adequately studied during pregnancy. It should be used only with extreme caution in women who are pregnant and is not recommended for nursing mothers.
Source: U.S. Food and Drug Administration (FDA); updated by Remedy Health Media