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Year : 2013  |  Volume : 4  |  Issue : 3  |  Page : 224-225  

A new drug belonging to a novel class of drugs for type 2 diabetes


Department of Pharmacology, Indira Gandhi Medical College and Research Institute, Kadhirkamam, Puducherry, India

Date of Web Publication5-Jul-2013

Correspondence Address:
G Sivagnanam
Department of Pharmacology, Indira Gandhi Medical College and Research Institute, Kadhirkamam, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-500X.114621

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How to cite this article:
Sivagnanam G. A new drug belonging to a novel class of drugs for type 2 diabetes. J Pharmacol Pharmacother 2013;4:224-5

How to cite this URL:
Sivagnanam G. A new drug belonging to a novel class of drugs for type 2 diabetes. J Pharmacol Pharmacother [serial online] 2013 [cited 2019 Nov 21];4:224-5. Available from: http://www.jpharmacol.com/text.asp?2013/4/3/224/114621


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Food and Drug Administration (FDA) approves Johnson and Johnson's first-in-class sodium-glucose cotransporter 2 (SGLT 2) inhibitor, Invokana for type 2 diabetes [1]


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The FDA approval of canagliflozin (Invokana) was based on data involving over 10,285 type 2 diabetes patients, which showed improvement in hemoglobin A1c and fasting plasma glucose levels. Canagliflozin has been tested as monotherapy as well as in combination with metformin, sulphonylurea, pioglitazone, and insulin. [1]

A protein called SGLT 2 (expressed almost exclusively in the proximal tubule and accounts for >90% of renal glucose reabsorption) plays a significant role in the kidneys, which is responsible for most renal glucose reabsorption in people with type 2 diabetes mellitus. Retention of excess glucose by this pathway contributes to persistent hyperglycemia and over time glucotoxicity that is deleterious to beta-cell function.

The SGLT2 receptor inhibitors are a new class of glucose-lowering agents. It is now known that suppressing the activity of SGLT2 in the body inhibits renal glucose reabsorption, thereby increasing the excretion of excess glucose from the body and assisting in the reduction of hyperglycemia. SGLT2 inhibitors do not stimulate insulin secretion and therefore are expected to be associated with a low risk for hypoglycemia. In addition, there is the potential for clinically significant weight loss, and as mentioned above, reduced hepatic glucose production, and amelioration of glucotoxicity.[2]

Since there are existing drugs, which are inexpensive and with a long safety record, it is unlikely that SGLT2 inhibitors would be used first line in type 2 diabetes. [3]

Improved glycemic control with a low risk of hypoglycemia, concomitant weight loss and the potential of lowering of blood pressure make SGLT2 inhibition an attractive approach. Many SGLT2 inhibitors (dapagliflozin, remogliflozin) are undergoing Phase III clinical trials and more are in Phase I and II clinical trials. [4]

 
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1.Available from: http://www.firstwordpharma.com/node/1068948. [Last accessed on 2013 Apr 24].  Back to cited text no. 1
    
2.List JF, Woo V, Morales E, Tang W, Fiedorek FT. Sodium-glucose cotransport inhibition with dapagliflozin in type 2 diabetes. Diabetes Care 2009;32:650-7.  Back to cited text no. 2
[PUBMED]    
3.Clar C, Gill JA, Court R, Waugh N. Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. BMJ Open 2012;2(5). pii: e001007. doi: 10.1136/bmjopen-2012-001007.  Back to cited text no. 3
    
4.Paisley AJ, Yadav R, Younis N, Rao-Balakrishna P, Soran H. Dapagliflozin: A review on efficacy, clinical effectiveness and safety. Expert Opin Investig Drugs 2013;22:131-40.  Back to cited text no. 4
    




 

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