A Novel Sodium-glucose Cotransporter Type 2 Inhibitor for the Treatment of Type 2 Diabetes Mellitus

Niren K. Shah, Pharm.D.; Wasim E. Deeb, M.D.; Rushab Choksi, Pharm.D.; Benjamin J. Epstein, Pharm.D.


Pharmacotherapy. 2012;32(1):80-94. 

In This Article


In spite of a reasonable complement of OADs and clear recommendations from guidelines and other authorities on the importance of blood glucose level control, diabetes remains a growing global health threat. Many patients with diabetes languish with poorly controlled blood glucose levels for many years, increasing the risk of micro- and macrovascular disease. Reasons for this disconnect are multifactorial but include underutilization and inadequacy of pharmacotherapy. Consequently, drugs being developed as treatment for type 2 diabetes, including SGLT2 inhibitors such as dapagliflozin, will be important for assuaging the future cost and health implications of diabetes.

Given dapagliflozin's distinctive mechanism of action, formidable efficacy, and acceptable safety profile, it will likely be a welcomed addition to the current antidiabetic drug portfolio. Dapagliflozin could afford clinicians an alternative to other agents that can cause hypoglycemia, weight gain, and edema, given that it has been shown to be associated with a low rate of hypoglycemia and promotes mild weight loss and diuresis. Its hypotensive actions might also compliment the actions of antihypertensive drugs in patients with coexisting diabetes and hypertension.

Additional studies are warranted to better characterize dapagliflozin's effects on urogenital infections and cardiovascular disease. Such studies will help clinicians better evaluate the risk-benefit profile of this new therapy. In the meantime, dapagliflozin will remain a tantalizing future option for treating the growing number of patients with diabetes destined to exhaust the currently available drugs.


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