Harms and benefits of sodium-glucose co-transporter 2 inhibitors

Sodium-glucose co-transporter 2 inhibitors are oral glucose-lowering drugs that increase the urinary excretion of glucose. In patients with type 2 diabetes and cardiovascular disease they reduce all-cause mortality, cardiac mortality, rates of hospitalisation for heart failure and the progression of renal disease. There are adverse effects related to the mechanism of action. These include polyuria and intravascular volume depletion from osmotic diuresis, and genitourinary infections from glycosuria. Ketoacidosis is a rare adverse effect. The glucose-lowering efficacy of sodium-glucose co-transporter 2 inhibitors decreases with increasing renal impairment.