The role of the kidneys in glucose homeostasis in type 2 diabetes: Clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors |
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| Authors: | John P.H. Wilding |
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| Affiliation: | Department of Obesity and Endocrinology, University of Liverpool, United Kingdom |
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| Abstract: | The kidneys play an important role in regulating glucose homeostasis through utilization of glucose, gluconeogenesis, and glucose reabsorption via sodium glucose co-transporters (SGLTs) and glucose transporters. The renal threshold for glucose excretion (RTG) is increased in patients with type 2 diabetes mellitus (T2DM), possibly due to upregulation of SGLT2 and SGLT1 expression. The resulting increase in renal glucose reabsorption is thought to contribute to the maintenance of hyperglycemia in patients with T2DM. Selective SGLT2 inhibitors reduce the RTG, thereby increasing glucosuria, and have demonstrated favorable efficacy and safety in patients with T2DM inadequately controlled with diet and exercise and other glucose-lowering treatments. |
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| Keywords: | ATPase, adenosine triphosphatase eGFR, estimated glomerular filtration rate EGP, endogenous glucose production FPG, fasting plasma glucose FRG, familial renal glucosuria GFR, glomerular filtration rate GGM, glucose-galactose malabsorption GLP-1, glucagon-like peptide-1 GLUT, glucose transporter HDL-C, high-density lipoprotein cholesterol LDL-C, low-density lipoprotein cholesterol RTG, renal threshold for glucose excretion SGLT, sodium glucose co-transporter TmG, tubular maximum glucose reabsorptive capacity T2DM, type 2 diabetes mellitus UGE, urinary glucose excretion |
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