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Dapagliflozin - knocking down barriers in the current treatment of diabetes mellitus

Abstract:

Diabetes mellitus (DM) is associated with a high degree of morbidity and premature mortality, a substantial shortening of life expectancy, a marked decrease in quality of life, and exorbitant financial costs. A large part of these problems may be attributed to important limitations for current antidiabetic treatment, considering that in general, metabolic control tends to be poor in patients with DM. These deficiencies have been the motivation for a revitalization of the molecular and clinical study of this diseases. In this scenario, SGLT2 inhibitors (SGLT2i) have achieved a great level of acceptance in clinical practice, by virtue of their robust efficacy, their benign tolerability profile, their versatility for implementation, and a plethora of pleiotropic effects in various organ systems. Among the different SGLT2i, dapagliflozin (DAP) stands out in this regard, as it appears to offer especially powerful nephroprotective and cardioprotective effects, with a markedly low risk of hypoglycemia. In type 2 DM, the utility of DAP has been documented, both in monotherapy and in combination with insulin therapy and other oral antidiabetic drugs. On the other hand, in type 1 DM, although fewer clinical data is available, preliminary evidence suggests good efficacy. In this review, we discuss the differential characteristics of DAP in basic and clinical pharmacology.