Role of sodium-glucose cotransporter 2 inhibition to mitigate diabetic kidney
disease risk in type 1 diabetes.
Authors van Raalte DH, Bjornstad P
Submitted By Petter Bjornstad on 2/12/2020
Status Published
Journal Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Year 2020
Date Published 1/1/2020
Volume : Pages 35 : i24 - i32
PubMed Reference 32003832
Abstract Diabetic kidney disease (DKD) is a common complication of type 1 diabetes (T1D)
and a major risk factor for premature death from cardiovascular disease (CVD).
Current treatments, such as control of hyperglycaemia and hypertension, are
beneficial, but only partially protect against DKD. Finding new, safe and
effective therapies to halt nephropathy progression has proven to be
challenging. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have
demonstrated, in addition to glycaemic lowering, impressive protection against
DKD and CVD progression in people with type 2 diabetes. Although these
beneficial cardiorenal effects may also apply to people with T1D, supporting
data are lacking. Furthermore, the increased rates of euglycaemic diabetic
ketoacidosis may limit the use of this class in people with T1D. In this review
we highlight the pathophysiology of DKD in T1D and the unmet need that exists.
We further detail the beneficial and adverse effects of SGLT2 inhibitors based
on their mechanism of action. Finally, we balance the effects in people with T1D
and indicate future lines of research.