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

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.

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.

By diaTribe.com

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

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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