Mode of action of Oral hypoglycemic Agents 

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, also known as gliflozins, are a class of oral hypoglycemic agents used to lower blood glucose levels in adults with type 2 diabetes.

Examples: Dapagliflozin, Empagliflozin etc. 

Mode of Action:

  1. They work by blocking the function of the SGLT2 protein within the kidneys (PCT, 90% glucose reabsorption). This protein is primarily tasked with the reabsorption of glucose from the glomerular ultrafiltrate. 
  2. By inhibiting SGLT2, these drugs prevent the reabsorption of glucose, leading to increased urinary glucose excretion.
  3. This mechanism corrects hyperglycemia independently of insulin. As a result, blood glucose levels are reduced. 


Note: In addition to their glucose-lowering effect, SGLT2 inhibitors have been found to have benefits on cardiovascular and renal outcomes, independent of their effects on blood glucose. They may also promote weight loss and modest improvements in blood pressure and blood cholesterol levels. 

ADRs

  1. Urinary tract infections (UTIs): SGLT2 inhibitors can increase the risk of developing UTIs.
  2. Yeast infections: Both men and women taking SGLT2 inhibitors are at an increased risk of genital yeast infections.
  3. Diabetic ketoacidosis
  4. Increased urination: SGLT2 inhibitors can lead to an increased frequency of urination.
  5. Glucosuria.  

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