Recent Advances in the Development of Type 2 Sodium-Glucose Cotransporter Inhibitors for the Treatment of Type 2 Diabetes Mellitus

Mini Rev Med Chem. 2022;22(4):586-599. doi: 10.2174/1389557521666210805112416.

Abstract

Background: Type 2 diabetes mellitus (T2DM) is one of the most serious and prevalent diseases worldwide. In the last decade, type 2 sodium-glucose cotransporter inhibitors (iSGLT2) were approved as alternative drugs for the pharmacological treatment of T2DM. The anti-hyperglycemic mechanism of action of these drugs involves glycosuria. In addition, SGLT2 inhibitors cause beneficial effects such as weight loss, a decrease in blood pressure, and others.

Objective: This review aimed to describe the origin of SGLT2 inhibitors and analyze their recent development in preclinical and clinical trials.

Results: In 2013, the FDA approved SGLT2 inhibitors as a new alternative for the treatment of T2DM. These drugs have shown good tolerance with few adverse effects in clinical trials. Additionally, new potential anti-T2DM agents based on iSGLT2 (O-, C-, and N-glucosides) have exhibited a favorable profile in preclinical evaluations, making them candidates for advanced clinical trials.

Conclusion: The clinical results of SGLT2 inhibitors show the importance of this drug class as new anti-T2DM agents with a potential dual effect. Additionally, the preclinical results of SGLT2 inhibitors favor the design and development of more selective new agents. However, several adverse effects could be a potential risk for patients.

Keywords: C-glycosides; FDA; SGLT2 inhibitors; Type 2 diabetes mellitus; anti-T2DM; glucosuria.

Publication types

  • Review

MeSH terms

  • Benzhydryl Compounds / pharmacology
  • Canagliflozin / therapeutic use
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucose
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Sodium / therapeutic use
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

  • Benzhydryl Compounds
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • Canagliflozin
  • Sodium
  • Glucose