J Korean Diabetes.  2019 Jun;20(2):74-80. 10.4093/jkd.2019.20.2.74.

Sodium-Glucose Cotransporter 2 Inhibitors: Mechanisms of Action and Various Effects

  • 1Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea. kks982@hanmail.net


The basic action mechanism of sodium-glucose cotransporter 2 (SGLT2) inhibitor is to lower the glucose burden by excreting the glucose filtered by the kidney into the urine. Although SGLT2 inhibitors are primarily indicated as glucose-lowering agents, they have a broad range of effects on renal function and plasma volume homeostasis, as well as on adiposity and energy metabolism across the entire body. That might be why SGLT2 inhibition causes spill-over of sodium and glucose beyond the proximal tubule, triggering dynamic and reversible realignment of energy metabolism, renal filtration, and plasma volume. A better understanding of SGLT2 inhibition in the kidney and the entire body will lead to more benefits in people with and without diabetes.


Diabetes mellitus; Molecular mechanisms of pharmacological action; Sodium-glucose transporter 2 inhibitors
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