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SGLT-2 inhibitors are a type of medication that people with type 2 diabetes can use to lower blood sugar levels.

How do SGLT-2 inhibitors lower blood sugar?

As our kidneys filter our blood, they also reabsorb glucose. SGLT-2 inhibitor drugs block the process of reabsorbing glucose back into our blood, causing glucose to be excreted through urine. Since extra glucose leaves the body instead of returning to the bloodstream, SGLT-2 inhibitors can lower the amount of sugar in the blood and, as a result, they can also lower A1C levels and body weight.

Who uses SGLT-2 inhibitors?

SGLT-2 inhibitors are currently approved for people with type 2 diabetes. They also improve kidney and heart failure outcomes in patients with chronic kidney disease and heart disease, regardless of diabetes status. SGLT-2s are especially useful for helping people with diabetes who have other diabetes-related health conditions, such as heart disease, heart failure, and kidney disease. Although not approved for people with type 1 diabetes, some healthcare professionals may prescribe SGLT-2s off-label to those with type 1 diabetes. Additionally, due to its many benefits, those with just heart failure and/or kidney disease may meet the requirements to be prescribed SGLT-2s. 

What are the benefits?

  • SGLT-2s are effective at lowering blood glucose and A1C levels.

  • SGLT-2s are taken orally (as pills), so they don’t need to be injected.

  • Some people who use SGLT-2s may experience a reduction in blood pressure and weight loss.

  • SGLT-2s protect against heart failure and are beneficial for those with heart failure with or without diabetes.

  • SGLT-2s slow the progression of kidney disease.

  • SGLT-2s have a relatively low risk of hypoglycemia.

What are the drawbacks?

  • Use of SGLT-2s can result in more frequent urination.

  • Increased glucose in the urinary tract can increase the risk of genital fungal infections.

  • SGLT-2s are a newer therapy and can be more expensive than other type 2 diabetes drugs, such as sulfonylureas, metformin, and TZDs.

  • Using SGLT-2s in type 1 diabetes increases the risk of – and decreases the ability to diagnose –  diabetic ketoacidosis (DKA), a dangerous complication that can become life-threatening if untreated.

Who should not use SGLT-2 drugs?

  • SGLT-2s should be used with caution if you have had a toe amputation and should be stopped entirely if you develop a toe ulcer 

Commonly used SGLT-2 drugs:

More information:

Chronic Kidney Disease and Heart Protection

SGLT-2s for Type 1 Diabetes

Last updated: August 2, 2021