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11-15-2016 | Sodium-glucose transporter-2 inhibitors | Article

Essentials of SGLT2 Inhibitors in Diabetes

4. Using SGLT2 Inhibitors in Special Populations

Author: MD Miles Fisher

Publisher: Springer International Publishing

Abstract

Type 2 diabetes is becoming a common problem in young obese people and, in some parts of the world, is as common as type 1 diabetes in teenagers and young adults. However, patients that are included in the Phase III trials of new antidiabetic drugs tend to be middle-aged and elderly and, at this point in time, there is little information on the effects of sodium glucose cotransporter 2 (SGLT2) inhibitors in patients under 19 or over 75 years of age. Similarly, until there is much more safety data on SGLT2 inhibitors, these drugs are untested in pregnancy and gestational diabetes or in patients with serious liver disease. In pregnancy, the renal threshold for glucose reduces (i.e., glucose spills over into the urine at a lower blood glucose concentration), and so different clinical effects can be anticipated when compared to the nonpregnant population. Thus, this chapter will omit these patients and focus on the effects of SGLT2 inhibitors in four specific groups of patients where there is published information on efficacy, safety, or both. This includes:

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