SGLT2 Inhibitors are a readily available group of medicines that were initially developed for diabetes. They have recently been shown to be capable of cutting the loss of kidney function in half.
Background
Each year, an estimated 1.5 million Americans are diagnosed with diabetes. The effect of diabetes on the kidneys varies greatly from person to person.
On average one out of every three people with adult-onset diabetes will develop early signs of kidney disease about ten years after developing high blood sugars. Within another 10 years many of them will need kidney dialysis.
In those with diabetes, their blood glucose, or blood sugar, levels are too high. Over time, this can damage the kidneys causing waste and fluids to build up in the blood instead of leaving the body. When kidney damage results from diabetes the condition is called diabetic nephropathy.
To reduce the risk of kidney damage, it’s important to manage your condition.
Fortunately, as more and more dollars are spent on diabetes research, physicians are continually learning about how to best prevent and manage it.
Part of this research includes the testing that the manufacturers currently do for new diabetes drugs, is to test the safety of these new medications on the kidneys and the heart.
As a result of this safety testing, several newer types of diabetes medications have been found to actually help treat both kidney and heart disease in adult-onset diabetics.
New Treatments for Kidney Disease in People with Adult Onset Diabetes
The most promising class of these new drugs, based on testing so far, are the SGLT2 inhibitors. This group includes Canagliflozin (invokana), Empaglifozin (Jardiance), Dapagliflozin (Farxiga), and Ertagliflozin (Steglatro).
Multiple long-term studies all indicate that when this class of drugs is used the loss of kidney function is more than cut in half in the first 4 years of use. This benefit was still holding strong at the end of the clinical trials.
Side effects seen early on have not been a big problem in these later large studies.
The American Diabetes Association (ADA) recommends considering these drugs for use in selected adult-onset diabetic patients, giving it their highest level of evidence grade. The ADA also retracted an earlier safety concern (June 3, 2019 ADA updates 11.3 and 11.8).
Some kidney experts now recommend using the SGLT2 class of drugs for its positive kidney and heart effects even if the diabetes is already well controlled.
Trials using these drugs in people without diabetes are ongoing and one trial recently published showed a benefit in patients with heart disease who did not even have diabetes.
For More Information
If you have adult-onset diabetes and have been told that you have some measure of kidney problems, then ask your doctor about whether this class of drugs could help you. Call Durham Nephrology at (919) 477-3005 or request an appointment online.
