Role of sodium-glucose cotransporter 2 inhibition to mitigate diabetic kidney disease risk in type 1 diabetes

Daniël H. van Raalte, Petter Bjornstad

Research output: Contribution to journalReview articleAcademicpeer-review

15 Citations (Scopus)

Abstract

Diabetic kidney disease (DKD) is a common complication of type 1 diabetes (T1D) and a major risk factor for premature death from cardiovascular disease (CVD). Current treatments, such as control of hyperglycaemia and hypertension, are beneficial, but only partially protect against DKD. Finding new, safe and effective therapies to halt nephropathy progression has proven to be challenging. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated, in addition to glycaemic lowering, impressive protection against DKD and CVD progression in people with type 2 diabetes. Although these beneficial cardiorenal effects may also apply to people with T1D, supporting data are lacking. Furthermore, the increased rates of euglycaemic diabetic ketoacidosis may limit the use of this class in people with T1D. In this review we highlight the pathophysiology of DKD in T1D and the unmet need that exists. We further detail the beneficial and adverse effects of SGLT2 inhibitors based on their mechanism of action. Finally, we balance the effects in people with T1D and indicate future lines of research.
Original languageEnglish
Pages (from-to)i24-i32
JournalNephrology, dialysis, transplantation
Volume35
Issue number1
DOIs
Publication statusPublished - 1 Jan 2020

Keywords

  • SGLT2 inhibitors
  • diabetic ketoacidosis
  • diabetic kidney disease
  • natriuresis
  • type 1 diabetes

Cite this