When to Use SGLT-2 Inhibitors for Type 2 Diabetes?

Gabby
By GabbyPA Latest Reply 2013-02-01 11:39:52 -0600
Started 2013-02-01 11:26:06 -0600

I'm sorry, but today was news day. I had a flood of great information come into my box today. So I posted some articles on the FDA approvals of a new line of drugs called SGLT-2 Inhibitors.
http://www.diabeticconnect.com/discussions/17...
http://www.diabeticconnect.com/discussions/17...

I had those, but didn't really know what the inhibitors do, so here is an article that explains that. My mind is swimming today with all the news.

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By diaTribe.com
http://diatribe.us/issues/51/learning-curve

There are two main ways in which SGLT-2 inhibitors like Invokana can become part of the type 2 diabetes treatment paradigm: as a first-line treatment or as part of a combination therapy. In isolation, SGLT-2 inhibitors would seem to have considerable potential as a first-line therapy, but the class looks less impressive when compared to other treatment options, particularly metformin. Even in the roughly 20% of people with type 2 diabetes who cannot tolerate metformin, SGLT-2 inhibitors will likely have difficulty replacing DPP-4 inhibitors, which provide slightly lower reductions in A1c but have the benefits of fewer side effects, more long-term safety data, and potentially lower cost. While there likely is a patient population for whom SGLT-2 inhibitors really are the best choice as a first-line therapy, identifying them would be a challenge for our current healthcare system – see this month’s letter from the editor for more thoughts on this tricky topic.

We mainly expect Invokana and future SGLT-2 inhibitors to be used as part of a combination type 2 diabetes therapy, either as a second- or third-line therapy. An SGLT-2 inhibitor in conjunction with a DPP-4 inhibitor could be a strong pairing for those who cannot tolerate metformin, although the cost of both medications could well prove prohibitive for many. Last year’s ADA/EASD Position Statement, which provided a framework for prescribing medications for type 2 diabetes, did not include SGLT-2 inhibitors, which is not surprising considering that at the time, no SGLT-2 inhibitor had gained regulatory approval in either the United States or Europe.

Read More: http://diatribe.us/issues/51/learning-curve


1 reply

Gabby
GabbyPA 2013-02-01 11:39:52 -0600 Report

The Doctor who is on the FDA board in this last link has his doubts. His insights are very helpful and will give us all pause.

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