Abstract
Prevalence of type 1 diabetes mellitus (T1DM) is globally continuously increasing.
T1DM is accompanied by a high risk of developing cardiovascular and renal comorbidities
and is one of the leading causes of end-stage renal disease (ESRD).
However, current therapeutic approaches for chronic and/or diabetic kidney disease
(CKD/DKD) existed for a long time, and offer room for improvement, particularly in
T1DM. In 2019, the European Medicines Agency (EMA) approved a first sodium/glucose
co-transporter 2 inhibitor (SGLT-2i) and a first dual SGLT-1/-2i to improve glycaemic
control, as an adjunctive treatment to insulin in persons with T1DM and a body mass
index ≥27 kg/m2. Of note, SGLT-1/2is and SGLT-2is are not approved by the Food and Drug Administration
(FDA) as an adjunct treatment in T1DM, nor approved for the treatment of CKD or DKD
by EMA and FDA.
SGLT is have shown to mediate different renoprotective effects in type 2 diabetes
mellitus in corresponding cardiovascular and renal outcome trials. First efficacy
trials offer insights into potential positive effects on renal function and kidney
disease of SGLTis in T1DM. This review summarizes and discusses latest available data
on SGLT inhibition and provides an update on the nephrological perspective on SGLTis,
specifically in T1DM.
Keywords
Abbreviations:
ACE-2 (angiotensin-converting-enzyme-2), ACEi (angiotensin-converting-enzyme inhibitor), AGEs (advanced glycosylation end-products), ARBs (angiotensin receptor blockers), BMI (body mass index), BP (blood pressure), Cana100/300 (canagliflozin 100mg / 300mg), CI (confidence interval), CKD (chronic kidney disease), CV (cardiovascular), CVD (cardiovascular disease), CVOTs (cardiovascular outcome trials), Dapa5/10 (dapagliflozin 5mg / 10mg), DBP (diastolic blood pressure), DEPICT (Dapagliflozin Evaluation in Patients with Inadequately Controlled Type 1 Diabetes), DKA (diabetic ketoacidosis), DKD (diabetic kidney disease), DM (diabetes mellitus), DPV (German Diabetes Prospective Follow-up Registry), EASE (Empagliflozin as Adjunctive to inSulin thErapy, EASE-program), eGFR (estimated glomerular filtration rate), EMA (European Medicines Agency), Empa10/25 (empagliflozin 10mg / 25mg), ESRD (end-stage renal disease), FDA (U.S. Food and Drug Administration), FGF-21 (fibroblast growth factor 21), GBM (glomerular basement membrane), HbA1c (glycated haemoglobin A1c), HR (hazard ratio), IR (insulin resistance), IU (international unit), LSM (least square matching), NaCl (sodium chloride), NALFD (non-alcoholic fatty liver disease), ND-CKD (non-diabetic chronic kidney disease), Nrf2 (nuclear factor erythroid 2-related factor 2), RAGE (receptor for advanced glycosylation end-products), RAS (renin-angiotensin-system), RCT (randomized controlled trial), ROS (reactive oxygen species), SBP (systolic blood pressure), SE (standard error), SGLT-1/-2is (dual sodium/glucose co-transporter 1 and 2 inhibitors), SGLT-2 (sodium/glucose co-transporter 2), SGLT-2is (sodium/glucose co-transporter 2 inhibitors), SGLTs (sodium/glucose co-transporters), Sota400 (sotagliflozin 400mg), STAT1 (signal transducer and activator of transcription 1), T1DM (type 1 diabetes mellitus), T1DX (U.S. Type 1 Diabetes Exchange Registry), T2DM (type 2 diabetes mellitus), TF (tubuloglomerular feedback), TGF-beta (transforming growth factor beta 1), TIR (time in range), UACR (urinary albumin-to-creatinine ratio), WHO (world health organization)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 21, 2020
Accepted:
September 16,
2020
Received in revised form:
September 10,
2020
Received:
July 20,
2020
Identification
Copyright
© 2020 Published by Elsevier B.V.
