The Emergence of Sodium glucose Co-transporter 2 Inhibitors as a Successful Agent for Management of Diabetes Mellitus

Most of current guidelines for management of diabetes mellitus are recommending comprehensive strategy inclusive of adequate control of blood pressure and weight apart from hyperglycemia . Several innovative anti-diabetic molecules have been launched in recent years. Out of these agents, injectable incretin based therapy like GLP 1 receptor agonist has shown great promise, but high cost and injectable route of administration have prevented their wide acceptance. In the last 4 years, sodium glucose co-transporter inhibitor, which works in kidney to induce excess glucose elimination through urine, has been launched globally. This oral anti-diabetic agent works comprehensively and more intensively than existing dipeptyl peptidase 4 inhibitors (DPP4i). Apart from its' excellent glycemic benefit with negligible risk of hypoglycemia, and extra-glycemic benefits like weight loss and blood pressure control, compatibility with almost all existing anti-diabetic agents, possible positive impact on cardiovascular and renal outcomes, and rapid reversal of glucotoxicity in type 2 diabetes mellitus patient whose renal function is intact, make them irresistible options for management of type 2 diabetes mellitus. However, despite huge advantages, injudicious ,use of agents this class throws up unique challenges like genito- urinary infections, eu-glycemic keto-acidosis, electrolyte imbalance etc.. This review tries to give a comprehensive and balanced view of this class of drug.