The role of sodium-glucose cotransporter 2 inhibitors in the treatment of type 2 diabetes: from clinical research to real practice

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In type 2 diabetes mellitus (T2DM), the development and progression of cardiovascular diseases occurs, which allows it to be considered as a cardiorenal metabolic syndrome. This should be taken into account when choosing hypoglycemic drugs. Patients with T2DM receiving insulin therapy often have a long history of diabetes, cardiovascular disease, chronic kidney disease, obesity, and need to be prescribed high doses of insulin and/or complex insulin therapy regimens to maintain glycemic control, which does not always lead to the achievement of target levels of glycemia and glycated hemoglobin (HbA1c). Adding to any insulin therapy regimen drugs from the class of sodium-glucose cotransporter type 2 inhibitors (SGLT-2), which have proven their cardio- and renoprotective properties, seems to be a rational combination in patients with T2DM and may have a number of advantages. The article presents 4 clinical examples of dapagliflozin administration, a drug from the SGLT2 class, to patients who are on insulin therapy, having T2DM with a  long history (10–26 years), as well as cardiovascular diseases, chronic kidney disease, and obesity. Dapagliflozin administration allowed to improve glycemic control, to stabilize the insulin dose, as well as reduce body weight without increasing the frequency of serious episodes of hypoglycemia in patients who initially received large doses of insulin. In the long term, we can expect reduction of the progression of cardiovascular risks and the risks of hospitalization due to existing complications of the disease.

About the authors

I. V. Misnikova

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
ORCID iD: 0000-0003-1668-8711

Inna V. Misnikova – MD, PhD, Leading Research Fellow, Department of Therapeutic Endocrinology 

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

Yu. A. Kovaleva

Moscow Regional Research and Clinical Institute (MONIKI)

ORCID iD: 0000-0001-7327-2486

Yulia A. Kovaleva – MD, PhD, Senior Research Fellow, Department of Therapeutic Endocrinology 

61/2 Shchepkina ul., Moscow, 129110

Russian Federation

V. A. Gubkina

Moscow Regional Research and Clinical Institute (MONIKI)

ORCID iD: 0000-0002-7813-8013

Valeriya A. Gubkina – MD, PhD, Senior Research Fellow, Department of Therapeutic Endocrinology 

61/2 Shchepkina ul., Moscow, 129110

Russian Federation


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Copyright (c) 2020 Misnikova I.V., Kovaleva Y.A., Gubkina V.A.

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