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Sodium-glucose cotransporter 2 inhibitors block SGLT2 protein involved in 90% of glucose reabsorption in the proximal renal tubule.
SGLT2 inhibitors produce A1C reductions up to 1%, have been associated with a mild reduction in blood pressure, and promote weight loss. SGLT2 inhibitors are insulin independent, removing the risk of hypoglycemia and rendering them appropriate at all stages of type 2 diabetes.
Canagliflozin, dapagliflozin, and empagliflozin all pose the risk of mycotic genitital infection and urinary tract infections as a result of glucosuria. The sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin was approved by the FDA on August 1, 2014, joining canagliflozin and dapagliflozin in the newest class of oral antihyperglycemic drugs indicated for the treatment of type 2 diabetes. This patient with type 1 diabetes noted a painful erosion at the site of tattoo she had gotten several days earlier.
Boehringer Ingelheim and Eli Lilly and Company received Marketing Authorization from the European Commission for linagliptin 5 mg film-coated tablets (to be marketed under the trade name Trajenta® in Europe) for the treatment of adults with type 2 diabetes.
The approval of linagliptin in Europe was based on a clinical trial program which involved approximately 6,000 adults with type 2 diabetes.
The most frequently reported adverse reaction was hypoglycemia observed with the triple combination of linagliptin plus metformin plus sulfonylurea. About DiabetesApproximately 25.8 million Americans(7) and an estimated 220 million people worldwide(8) have type 1 and type 2 diabetes. Boehringer Ingelheim and Eli Lilly and CompanyIn January 2011, Boehringer Ingelheim and Eli Lilly and Company announced an alliance in the field of diabetes that centers on four pipeline compounds representing several of the largest treatment classes. As a central element of its culture, Boehringer Ingelheim pledges to act socially responsible. About Eli Lilly and CompanyLilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. About Lilly DiabetesFor more than 85 years, Lilly has been a worldwide leader in pioneering industry-leading solutions to support people living with and treating diabetes. Hypothyroidism is a common and potentially serious endocrine disorder in the general population.

The physiological effects of hypothyroidism are widespread and include cardiovascular, renal, gastrointestinal, neurological, and endocrine abnormalities. SGLT2 inhibitors also pose a risk for polyuria, volume depletion and increased glucagon levels. This effect is influenced by several factors including: baseline HgbA1c of patients in clinical trials, duration and severity of disease (beta-cell function remaining), and drug’s mechanism of action. These agents block the reabsorption of glucose form the proximal renal tubules and so act independently of insulin levels.
Food and Drug Administration (FDA) in May 2011 to be used along with diet and exercise to lower blood sugar in adults with type 2 diabetes.
A1C is measured in people with diabetes to provide an index of blood glucose control for the previous two to three months and is used as a marker to determine the efficacy of glucose-lowering therapies.
This alliance leverages the companies' strengths as two of the world's leading pharmaceutical companies, combining Boehringer Ingelheim's solid track record of research-driven innovation and Lilly's innovative research, experience, and pioneering history in diabetes. Headquartered in Ingelheim, Germany, it operates globally with 145 affiliates and more than 42,000 employees. Involvement in social projects, caring for employees and their families, and providing equal opportunities for all employees form the foundation of the global operations. Headquartered in Indianapolis, IN, Lilly provides answers - through medicines and information - for some of the world's most urgent medical needs.
Lilly introduced the world's first commercial insulin in 1923, and remains at the forefront of medical and delivery device innovation to manage diabetes. They are appropriate for use at all stages of disease—not affected by beta cell function or insulin sensitivity.The slides above offer snapshots of the known advantages and disadvantages of the SGLT2 inhibitors. Linagliptin should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis (increased ketones in the blood or urine). By joining forces, the companies demonstrate commitment in the care of patients with diabetes and stand together to focus on patient needs. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine.

Mutual cooperation and respect, as well as environmental protection and sustainability are intrinsic factors in all of Boehringer Ingelheim's endeavors. Lilly is also committed to providing solutions beyond therapy - practical tools, education, and support programs to help overcome barriers to success along the diabetes journey. Linagliptin is also approved for use in other countries, including Japan (trade name Trazenta). From history to reality: sodium glucose co-transporter 2 inhibitors – a novel therapy for type 2 diabetes mellitus.
Dapagliflozin in patients with type 2 diabetes receiving high doses of insulin: efficacy and safety over 2 years.
Efficacy and safety of canagliflozin over 52 weeks in patients with type 2 diabetes on background metformin and pioglitazone. The role of the kidney and sodium-glucose cotransporter 2 inhibition in diabetes management. Efficacy and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, as add-on to metformin in type 2 diabetes with mild hyperglycaemia. Efficacy and safety of canagliflozin over 52 weeks in patients with type 2 diabetes on background metformin and pioglitazone Diabetes Obes  Metab. Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomised, double-blind, phase 3 non-inferiority trial.
Vulvovaginitis and balanitis in patients with diabetes treated with dapagliflozin.  J Diabetes Complications. Metabolic response to sodium glucose cotransporter 2 inhibition in type 2 diabetic patients.  J Clin Invest. Dapagliflozin improves muscle insulin sensitivity but enhances endogenous glucose production.  J Clin Invest.

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