Novel Class of Diabetes Drug Could Protect Kidney Function

SGLT2 inhibitors can lower blood glucose levels and potentially protect the kidneys.

Findings from a recent study have shown that a class of diabetes drugs could potentially preserve kidney health, while lowering blood glucose levels.

This drug class inhibits the sodium-glucose cotransporter 2 (SGLT2) in the kidney, and alters the excretion of glucose in the urine to lower blood sugar. The effects can lower blood pressure and body weight, as well.

In a study published by the Journal of the American Society of Nephrology, researchers analyzed data from a clinical trial that compared canagliflozin, a SGLT2 inhibitor, and glimepiride, a sulfonylurea. There were 1450 patients with type 2 diabetes taking metformin included in the study.

Patients were either given 100-mg or 300-mg of canagliflozin or glimepiride uptitrated to 6- to 8-mg. Researchers measured estimated glomerular filtration rate (eGFR) to assess kidney function.

Overall, glimepiride, canagliflozin 100-mg, and canagliflozin 300-mg groups had eGFR declines of 3.3, 0.5, and 0.9 ml/min per 1.73 m2 per year, respectively. Patients who received glimepiride, canagliflozin 100-mg, or canagliflozin 300-mg had decreases in HbA1c of 0.81%, 0.82%, and 0.93%, respectively, at 1 year. HbA1c was reduced 0.55%, 0.65%, and 0.74%, respectively, at 2 years.

Researchers found that patients treated with canagliflozin had reduced decline in kidney function compared with patients treated with glimepiride, according to the study. Both drugs had similar effects on blood sugar.

“Since glycemic control was only modestly different between canagliflozin and glimepiride, our results suggest that potential kidney protective effects of canagliflozin may be unrelated to glycemic control,” said lead researcher Hiddo Lambers Heerspink, PhD. “Our results are especially important since many patients with diabetes are at risk of progressive kidney function loss and canagliflozin may offer a new and improved therapeutic opportunity for these patients.”