Diabetes Metab J.  2020 Feb;44(1):11-32. 10.4093/dmj.2019.0208.

Use of SGLT-2 Inhibitors in Patients with Type 2 Diabetes Mellitus and Abdominal Obesity: An Asian Perspective and Expert Recommendations

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
  • 2Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
  • 3Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
  • 4Department of Internal Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
  • 5Division of Endocrinology and Diabetes, The Medicity, Gurgaon, India.
  • 6Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
  • 7Department of Internal Medicine, Sanglah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia.
  • 8Department of Medicine, National University Health System, Singapore.
  • 9The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
  • 10Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking, China.
  • 11Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea. yoonk@catholic.ac.kr

Abstract

The prevalence of obesity in Asia is of epidemic proportions, with an estimated 1 billion overweight/obese individuals in the region. The majority of patients with type 2 diabetes mellitus (T2DM) are overweight/obese, which increases the risk of cardiorenal outcomes in these patients; hence, sustained reductions in body weight and visceral adiposity are important management goals. However, most of the glucose-lowering therapies such as insulin, sulfonylureas, glinides, and thiazolidinediones induce weight gain, which makes the management of overweight/obese T2DM patients challenging. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are the only oral glucose-lowering agents that have been shown to reduce body weight and visceral adiposity. In addition, SGLT-2 inhibitors therapy reduces ectopic fat deposition and improves adipose tissue function and weight-related quality of life. In this article, we aim to consolidate the existing literature on the effects of SGLT-2 inhibitors in Asian patients with T2DM and to produce clinical recommendations on their use in overweight or obese patients with T2DM. Recommendations from international and regional guidelines, as well as published data from clinical trials in Asian populations and cardiovascular outcomes trials are reviewed. Based on the available data, SGLT-2 inhibitors represent an evidence-based therapeutic option for the management of overweight/obese patients with T2DM.

Keyword

Diabetes mellitus, type 2; Obesity; Sodium-glucose transporter 2 inhibitors

MeSH Terms

Adipose Tissue
Adiposity
Asia
Asian Continental Ancestry Group*
Body Weight
Diabetes Mellitus, Type 2*
Humans
Insulin
Obesity
Obesity, Abdominal*
Overweight
Prevalence
Quality of Life
Thiazolidinediones
Weight Gain
Insulin
Thiazolidinediones

Figure

  • Fig. 1 Proposed mechanisms of effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on body weight and fat mass.


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Diabetes Metab J. 2023;47(1):82-91.    doi: 10.4093/dmj.2021.0356.

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Diabetes Metab J. 2023;47(6):796-807.    doi: 10.4093/dmj.2022.0315.


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