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

• Sheu WH
• Chan SP
• Matawaran
• Deerochanawong C
• Mithal A
• Chan J
• Suastika K
• Khoo CM
• Nguyen HM
• Linong J
• Luk A
• Yoon KH

• KMID: 2470952
• DOI: http://doi.org/10.4093/dmj.2019.0208

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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