Essay Example on Newest oral Antihyperglycemic medications to be Approved

Sodium glucose co transporter 2 inhibitors SGLT2i are the newest oral antihyperglycemic medications to be approved in 2013 by the Food and Drug Administration FDA for the treatment of patients with type 2 diabetes mellitus T2DM SGLT2 inhibitors help in reduction in blood glucose without stimulating insulin release It also help weight loss and decrease blood pressure Its use is rising and is being one of the favorites among clinicians In 2015 FDA released warning about Diabetes Ketoacidosis with normal glucose EuDKA as potential side effect of SGLT2i In this review we tried to investigate the relationship between SGLT 2 inhibitor and EuDKA in patients with diabetes Numerous databases were searched to identify appropriate primary literature Search terms included SGLT2 sodium glucose cotransporter 2 inhibitor diabetic ketoacidosis ketoacidosis metabolic acidosis and Euglycemic diabetes ketoacidosis Primary literatures and case reports were searched on Pubmed Cochrane library and Google Cases of DKA taking SGLT 2 with blood sugar below 250mg dl at presentation were only included Total of 26 cases were included for this review 38 patient were T1DM and 61 were T2DM with average blood glucose of 170 3 43 3 mg dl 77 cases were taking Canagliflozin All cases had low pH and high Anion Gap during presentation Major precipitating factors for T2DM were reduction in insulin dose where surgery and infection triggered DKA in most of T2DM Most common symptoms were vomiting Nausea and abdomen pain Diagnosis difficulties were present due to non markedly elevated blood sugar with three cases of misdiagnosis and delayed treatment 

This glucose is reabsorbed by Sodium-glucose co-transporter proteins at proximal tubules of the kidney There are several types of SGLT proteins that are insulin-independent and inhibiting these proteins resulted in changes that improved carbohydrate metabolism which became an attractive concept for the treatment of diabetes8 SGLT1 proteins are high-affinity low capacity transporters of glucose which are found in the small intestines and the proximal tubule of the kidneys whereas SGLT2 proteins are found in the proximal convoluted tubule of the kidneys The SGLT1 proteins in the proximal convoluted tubule of the kidneys are responsible for less than 10 of filtered glucose reabsorption whereas SGLT2 proteins are responsible for roughly 90 of filtered glucose reabsorption making it a genuine target for diabetes treatment 5 Also SGLT1 has more gastrointestinal side effects like severe diarrhea due to involvement in small intestine 9