[Sodium-glucose cotransporter type 2 inhibitors (SGLT2): from familial renal glucosuria to the treatment of type 2 diabetes mellitus]

Nefrologia. 2010;30(6):618-25. doi: 10.3265/Nefrologia.pre2010.Sep.10494.
[Article in Spanish]

Abstract

For centuries, the kidney has been considered primarily an organ of elimination and a regulator of salt and ion balance. Although once thought that the kidney was the structural cause of diabetes, which in recent years has been ignored as a regulator of glucose homeostasis, is now recognized as a major player in the field of metabolic regulation carbohydrate. During fasting, 55% of the glucose comes from gluconeogenesis. Only 2 organs have this capability: the liver and kidney. The latter is responsible for 20% of total glucose production and 40% of that produced by gluconeogenesis. Today we have a better understanding of the physiology of renal glucose transport via specific transporters, such as type 2 sodium-glucose cotransporter  (SGLT2). A natural compound, phlorizin, was isolated in early 1800 and for decades played an important role in diabetes and renal physiology research. Finally, at the nexus of these findings mentioned above, recognized the effect of phlorizin-like compounds in the renal glucose transporter, which has offered a new mechanism to treat hyperglycemia. This has led to the development of several potentially effective treatment modalities for the treatment of diabetes.

Publication types

  • Review

MeSH terms

  • Absorption
  • Animals
  • Benzhydryl Compounds
  • Diabetes Mellitus, Experimental / drug therapy
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Dogs
  • Double-Blind Method
  • Gluconeogenesis / drug effects
  • Glucose / metabolism
  • Glucosides / adverse effects
  • Glucosides / pharmacology
  • Glucosides / therapeutic use*
  • Glycosuria, Renal / drug therapy*
  • Glycosuria, Renal / genetics
  • Glycosuria, Renal / metabolism
  • Homeostasis
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use*
  • Kidney / metabolism
  • Kidney / physiopathology
  • Kidney Tubules, Proximal / metabolism
  • Mice
  • Phlorhizin / adverse effects
  • Phlorhizin / pharmacokinetics
  • Phlorhizin / pharmacology
  • Phlorhizin / therapeutic use
  • Randomized Controlled Trials as Topic
  • Sodium-Glucose Transporter 1 / physiology
  • Sodium-Glucose Transporter 2 / genetics
  • Sodium-Glucose Transporter 2 / physiology
  • Sodium-Glucose Transporter 2 Inhibitors*

Substances

  • Benzhydryl Compounds
  • Glucosides
  • Hypoglycemic Agents
  • SLC5A1 protein, human
  • SLC5A2 protein, human
  • Sodium-Glucose Transporter 1
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • dapagliflozin
  • Phlorhizin
  • Glucose