Diabetes mellitus is one of the most prevalent chronic disorders in the world today with the highest death and fatality rates, thereby emerging as a considerably negative socioeconomic impact. Defining Type 2 diabetes, it is a paradoxical metabolic disorder identified by hyperglycemia resulting from the combination of inadequate insulin secretion concomitantly with resistance to insulin action. It’s true that the incidence and prevalence of type 2 diabetes are rising regularly, fed in part by a concomitant increase in the worldwide rates of obesity.
Looking at the remedial part, although there were several classes of oral anti-diabetic agents, most of the patients were found to be outside the remedial goal range. To provide a much wider resolution various clinical trials were done which led to the discovery of new agents that exhibited improved efficacy and safety relative to currently available medicines. Below we have discussed some of them.
In type 2 diabetes, the blood sugar may be too high after a meal, even if you consume very little carbohydrate (CHO). This is because of glucagon levels lingering too high after meals. In order to provide a healthy outcome, the incretin-based treatments were introduced making it possible to control post-meal glucagon and help reduce the post-meal blood sugars.
These drugs were blood sugar normalizing medications which promised that the blood sugar levels should return back to the normal range. For your knowledge, Incretins are gut-derived hormones that are emitted at low basal levels in the fasting state. The two most freshly approved classes of therapeutic agents for the treatment of type 2 diabetes are the glucagon-like peptide-1 (GLP-1) receptor (GLP-1R) agonists and dipeptidyl peptidase-4 inhibitors (DPP-4i) which exercise their operations through potentiation of incretin receptor signaling.
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most current addition to the remedial possibilities available for the handling of type 2 diabetes. It became acceptable after the initiation of incretin-based therapies, dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs).
These inhibitors are a class of oral antidiabetic drugs which are directed to the kidney and their mechanism of action is to reduce blood glucose by inducing glycosuria. There have been extravagant glycemic benefits which have been reported, such as weight loss, a decline in blood pressure and even in levels of triglycerides and uric acid, thereby slowing the progression of kidney disease. They have also brought a reduction in episodes of cardiovascular events in high-risk patients.
SGL2 inhibitor has also reported clinically important outcomes, and have also corrected some core defects present in type 2 diabetes by putting a marked impression on the in-cell function and insulin sensitivity.
Significantly, the new SGLTi drugs have an extremely welcome response and slightly unexpected cardiac and renal protective impacts. Though their underlying mechanisms are not fully known, the cardiovascular and renal benefits have led to great enthusiasm for the SGLTi drugs and its increasing clinical use.
Consideration of their use shortly after metformin is recommended for patients with Type 2 Diabetes with established cardiovascular disease. Now we need to know whether these agents can be as effective for patients with Type 2 Diabetes not accompanied by clear cardiovascular or renal disease, or for cardiac patients without diabetes and how about prescribing these agents along with basal-bolus insulin for type 1 diabetes.
So if you or someone in your family feels confused about the Sodium-glucose cotransporter 2 inhibitors (SGLT2i) do not hesitate but rather visit Dharma diabetic and metabolic clinic which is governed by best Diabetic doctor in Delhi Dr Mudit Sabharwal (diabetic consultant)
Tags: Type2 DiabetesCategorised in: Diabetes