Effect of SGLT2 Inhibitors and Dietary Therapy

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce blood glucose levels by inhibiting glucose reabsorption from primary urine via SGLT2, expressed in the proximal renal tubule. Although SGLT2 inhibitors were initially developed as a treatment for diabetes mellitus, several clinical trials revealed that they reduced the risk of heart and renal failure, irrespective of glucose intolerance. SGLT2 inhibitors bring multifaceted benefits when used safely, but have a notable side effect that warrants caution: euglycemic ketoacidosis. To mitigate this risk, attention to dietary management is crucial. Specifically, it is important not to follow a low-carbohydrate diet. Additionally, it is recommended to discontinue SGLT2 inhibitors before any major planned surgery and to withdraw them in the event of severe emergency hospitalization. During periods of fasting, it is essential to adequately supplement glucose intravenously.