Terapi penghambat Sodium Glucose Co-Transporters-2 (SGLT-2) dalam pengobatan Diabetes Melitus Tipe-2 (DM-2): tinjauan pustaka

Andre Hendrajaya

doi:10.15562/ism.v12i1.852

Terapi penghambat Sodium Glucose Co-Transporters-2 (SGLT-2) dalam pengobatan Diabetes Melitus Tipe-2 (DM-2): tinjauan pustaka

Andre Hendrajaya ,

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DOI: https://doi.org/10.15562/ism.v12i1.852 |
Published: 2021-04-01

Abstract

Management of type II diabetes mellitus is a science that continues to develop. Treatment of type II diabetes mellitus can affect various organ functions, one of which is the kidneys, which function to excrete glucose, namely SGLT II inhibitors. The class of sodium-glucose transport protein 2 (SGLT2) inhibitors has a new mechanism of action and is complementary to the older drugs used to treat type II diabetes. The sodium-glucose cotransporter-2 (SGLT2) protein is expressed in the proximal tubule of the renal convolution. These transporters are ideal targets for the treatment of diabetes because they account for approximately 90% of filtered glucose reabsorption SGLT2 inhibitors can be a useful option in obese and hypertensive patients because of their weight loss and antihypertensive benefits and thus benefit cardiovascular function. Patients at high risk for hypoglycemia may benefit from a combination of metformin and SGLT2 inhibitors because the risk of hypoglycemia with SGLT2 inhibitors is small when compared with insulin and sulfonylurea.

Tatalaksana DM mellitus tipe II merupakan ilmu yang terus berkembang. Pengobatan DM tipe II dapat mempengaruhi berbagai fungsi organ, salah satunya adalah ginjal yang berfungsi untuk mengeksreksikan glukosa yakni penghambat SGLT II. Kelas obat penghambat sodium-glukosa transport protein 2 (SGLT2) memiliki karakteristik ini, dan mekanisme aksi yang baru melengkapi obat yang lebih lama yang digunakan untuk mengobati DM tipe II. Protein sodium-glukosa cotransporter-2 (SGLT2) diekspresikan dalam tubulus proksimal konvolusi ginjal. Transporter ini adalah target yang ideal untuk pengobatan diabetes karena mereka bertanggung jawab atas sekitar 90% dari reabsorpsi glukosa yang difiltrasi Inhibitor SGLT2 dapat menjadi pilihan yang berguna pada pasien obesitas dan hipertensi karena penurunan berat badan dan manfaat antihipertensi sehingga memberikan manfaat terhadap fungsi kardiovaskular. Pasien yang berisiko tinggi untuk hipoglikemia dapat mengambil manfaat dari kombinasi metformin dan inhibitor SGLT2 karena risiko hipoglikemia dengan inhibitor SGLT2 kecil jika dibandingkan dengan insulin dan sulfonylurea.

References

Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J. 2012;27(4):269-273.
Aschner P. Recent advances in understanding/managing type 2 diabetes mellitus. F1000Res. 2017;6:F1000 Faculty Rev-1922.
Apovian CM, Okemah J, O'Neil PM. Body Weight Considerations in the Management of Type 2 Diabetes. Adv Ther. 2019;36(1):44-58.
Schwartz SS, Kohl BA. Glycemic control and weight reduction without causing hypoglycemia: the case for continued safe aggressive care of patients with type 2 diabetes mellitus and avoidance of therapeutic inertia. Mayo Clin Proc. 2010;85(12 Suppl):S15-S26.
Plodkowski RA, McGarvey ME, Huribal HM, Reisinger-Kindle K, Kramer B, Solomon M, et al. SGLT2 Inhibitors for Type 2 Diabetes Mellitus Treatment. Fed Pract. 2015 Oct;32(Suppl 11):8S-15S.
Robson L. The kidney--an organ of critical importance in physiology. J Physiol. 2014;592(18):3953-3954.
Navale AM, Paranjape AN. Glucose transporters: physiological and pathological roles. Biophys Rev. 2016;8(1):5-9.
Vallon V, Platt KA, Cunard R, Schroth J, Whaley J, Thomson SC, et al. SGLT2 mediates glucose reabsorption in the early proximal tubule. J Am Soc Nephrol. 2011;22(1):104-12.
Wilding JP. The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors. Metabolism. 2014;63(10):1228-1237.
Shannon JA, Fisher S. The renal tubular reabsorption of glucose in the normal dog. Amer J Physiol. 1938;122:165.
Hsia DS, Grove O, Cefalu WT. An update on sodium-glucose co-transporter-2 inhibitors for the treatment of diabetes mellitus. Curr Opin Endocrinol Diabetes Obes. 2017;24(1):73-79.
Chao EC. SGLT-2 Inhibitors: A New Mechanism for Glycemic Control. Clin Diabetes. 2014;32(1):4-11.
Mudaliar S, Polidori D, Zambrowicz B, Henry RR. Sodium-Glucose Cotransporter Inhibitors: Effects on Renal and Intestinal Glucose Transport: From Bench to Bedside. Diabetes Care. 2015;38(12):2344-2353.
Inzucchi SE, Zinman B, Wanner C, Ferrari R, Fitchett D, Hantel S, et al. SGLT-2 inhibitors and cardiovascular risk: proposed pathways and review of ongoing outcome trials. Diab Vasc Dis Res. 2015;12(2):90-100.
Novikov A, Vallon V. Sodium glucose cotransporter 2 inhibition in the diabetic kidney: an update. Curr Opin Nephrol Hypertens. 2016;25(1):50-58.
Mulyani WRW, Sanjiwani MID, Sandra, Prabawa IPY, Lestari AAW, Wihandani DM, et al. Chaperone-Based Therapeutic Target Innovation: Heat Shock Protein 70 (HSP70) for Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2020;13:559-568.

[1] Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J. 2012;27(4):269-273.

[2] Aschner P. Recent advances in understanding/managing type 2 diabetes mellitus. F1000Res. 2017;6:F1000 Faculty Rev-1922.

[3] Apovian CM, Okemah J, O'Neil PM. Body Weight Considerations in the Management of Type 2 Diabetes. Adv Ther. 2019;36(1):44-58.

[4] Schwartz SS, Kohl BA. Glycemic control and weight reduction without causing hypoglycemia: the case for continued safe aggressive care of patients with type 2 diabetes mellitus and avoidance of therapeutic inertia. Mayo Clin Proc. 2010;85(12 Suppl):S15-S26.

[5] Plodkowski RA, McGarvey ME, Huribal HM, Reisinger-Kindle K, Kramer B, Solomon M, et al. SGLT2 Inhibitors for Type 2 Diabetes Mellitus Treatment. Fed Pract. 2015 Oct;32(Suppl 11):8S-15S.

[6] Robson L. The kidney--an organ of critical importance in physiology. J Physiol. 2014;592(18):3953-3954.

[7] Navale AM, Paranjape AN. Glucose transporters: physiological and pathological roles. Biophys Rev. 2016;8(1):5-9.

[8] Vallon V, Platt KA, Cunard R, Schroth J, Whaley J, Thomson SC, et al. SGLT2 mediates glucose reabsorption in the early proximal tubule. J Am Soc Nephrol. 2011;22(1):104-12.

[9] Wilding JP. The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors. Metabolism. 2014;63(10):1228-1237.

[10] Shannon JA, Fisher S. The renal tubular reabsorption of glucose in the normal dog. Amer J Physiol. 1938;122:165.

[11] Hsia DS, Grove O, Cefalu WT. An update on sodium-glucose co-transporter-2 inhibitors for the treatment of diabetes mellitus. Curr Opin Endocrinol Diabetes Obes. 2017;24(1):73-79.

[12] Chao EC. SGLT-2 Inhibitors: A New Mechanism for Glycemic Control. Clin Diabetes. 2014;32(1):4-11.

[13] Mudaliar S, Polidori D, Zambrowicz B, Henry RR. Sodium-Glucose Cotransporter Inhibitors: Effects on Renal and Intestinal Glucose Transport: From Bench to Bedside. Diabetes Care. 2015;38(12):2344-2353.

[14] Inzucchi SE, Zinman B, Wanner C, Ferrari R, Fitchett D, Hantel S, et al. SGLT-2 inhibitors and cardiovascular risk: proposed pathways and review of ongoing outcome trials. Diab Vasc Dis Res. 2015;12(2):90-100.

[15] Novikov A, Vallon V. Sodium glucose cotransporter 2 inhibition in the diabetic kidney: an update. Curr Opin Nephrol Hypertens. 2016;25(1):50-58.

[16] Mulyani WRW, Sanjiwani MID, Sandra, Prabawa IPY, Lestari AAW, Wihandani DM, et al. Chaperone-Based Therapeutic Target Innovation: Heat Shock Protein 70 (HSP70) for Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2020;13:559-568.

Terapi penghambat Sodium Glucose Co-Transporters-2 (SGLT-2) dalam pengobatan Diabetes Melitus Tipe-2 (DM-2): tinjauan pustaka

Abstract

References

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