Canagliflozin in the treatment of diabetes: Perspectives

Abstract

The worldwide prevalence of type 2 diabetes mellitus (T2DM) has surpassed more than 380 million people in 2014 and the projections of new T2DM cases for the next years are not encouraging. At present, combination of diet and exercise do not guarantee an adequate control of glucose homeostasis in T2DM patients. Thus, oral agents that act improving peripheral insulin sensitivity and/or pancreatic beta-cell function are additionally used as monotherapy or in combination. However, many patients still experience inadequate control with the pharmacotherapy ‘weapons’ currently available. Canagliflozin is a novel selective inhibitor of sodium-glucose co-transporter 2 (SGLT2) that lowers blood glucose concentration mainly by augmenting urinary glucose excretion. Besides having an effective action in reducing HbA1c, canagliflozin treatment also may benefit those patients aiming to control body weight, blood pressure and hypoglycemia episodes since this drug positively impact on such parameters. Among the adverse effects, genital infections are the most frequent. Much caution is required for some groups of patients including those elderly and with chronic kidney disease since canagliflozin can worse their quality of life. Given its overall cardiometabolic improvements, canagliflozin seems to be an important ally to the treatment of a selective group of T2DM patients and its efficacy and safety must be kept under monitoring through long-term clinical trials as well as experimental studies to certify whether this class of drug comes to stay among T2DM therapy.