Place of Sodium–glucose Cotransporter-2 inhibitors in East Asian subjects with Type 2 Diabetes Mellitus: Insights into the management of Asian phenotype

• Published in: Journal of diabetes and its complications 2017-02, Vol.31 (2), p.494-503
• Main Authors: Lim, Lee Ling, Tan, Alexander Tong Boon, Moses, Kevin, Rajadhyaksha, Viraj, Chan, Siew Pheng
• Format: Article
• Language: English
• Subjects: Asian Continental Ancestry Group; Asian people; Benzhydryl Compounds - adverse effects; Benzhydryl Compounds - therapeutic use; Body mass index; Canagliflozin - adverse effects; Canagliflozin - therapeutic use; Cardiovascular outcome; Diabetes Complications - ethnology; Diabetes Complications - prevention & control; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - metabolism; East Asians; Endocrinology & Metabolism; Evidence-Based Medicine; Glucose; Glucosides - adverse effects; Glucosides - therapeutic use; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin resistance; Insulin Resistance - ethnology; Membrane Transport Modulators - adverse effects; Membrane Transport Modulators - therapeutic use; Middle Aged; Obesity; Renoprotection; Reproducibility of Results; SGLT2 inhibitors; Sodium-Glucose Transporter 2 - metabolism; Sodium-Glucose Transporter 2 Inhibitors; Type 2 diabetes; Visceral adiposity
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2016.10.008

Abstract The burden of type 2 diabetes (T2DM) in East Asia is alarming. Rapid modernization and urbanization has led to major lifestyle changes and a tremendous increase in the prevalence of obesity, metabolic syndrome, and diabetes mellitus. The development of T2DM at a younger age, with lower body mass index, higher visceral adiposity, and more significant pancreatic beta-cell dysfunction compared to Caucasians are some of the factors responsible for the increased prevalence of T2DM in East Asians. Sodium–glucose Cotransporter-2 (SGLT2) inhibitors (canagliflozin, dapaglifozin, empagliflozin, etc.) reduce renal glucose reabsorption, leading to favorable effects on glycemic, blood pressure, and weight control. The insulin-independent mechanism enables their use as monotherapy or combination therapy with insulin and other oral antidiabetic agents. The role of SGLT2 inhibitors in the management of T2DM among East Asians is an interesting area of research, given that East Asians have been proven to be uniquely different from Caucasians. This review provides comprehensive coverage of the available literature not only on the efficacy and safety, but also the recent cardiovascular and renal outcomes of SGLT2 inhibitors, focusing among East Asians.