The pharmaceutical industry is actively discussing merits of sodium-glucose transport protein 2 (SGLT-2) inhibitors and precautions in prescribing them. SGLT-2 inhibitors are antidiabetic treatments to lower blood sugar and cardiovascular disease risks.

Cardiovascular disease is the most common cause of death in type-2 diabetes patients, accounting for half of all deaths of type-2 diabetes patients in the world.

Large-sized clinical trials have shown that SGLT-2 inhibitors could reduce cardiovascular risk, and local physicians are increasingly prescribing the treatments.

“SGLT-2 inhibitors have several advantages, including ketone body formation, blood sugar improvement, and uric acid reduction. Clinical studies have revealed that they lowered insulin resistance, in particular,” said Lim Soo, a professor at internal medicine department of Seoul National University Bundang Hospital, at a news conference hosted by Boehringer Ingelheim Korea on Thursday.

Lim said although insulin resistance-confirming studies used AstraZeneca’s Forxiga (dapagliflozin), another SGLT-2 inhibitor Boehringer Ingelheim’s Jardiance (empagliflozin) would have a similar effect.

However, Lim warned that physicians should take extra caution when administering an SGLT-2 inhibitor to patients with high risk of genital tract infection.

“In Korea, prescription of the treatment should be more carefully made to women with a possibility of vagina infection than to men who are mostly circumcised,” Lim said.

People with such risk are only 3 percent of type-2 diabetes patients, he noted, adding that SGLT-2 inhibitors have a lot more advantages than disadvantages.

At the press conference, Boehringer Ingelheim presented “Clinical implications of current cardiovascular outcome trials with SGLT-2 inhibitors,” which was published in March on international journal Atherosclerosis.

Citing the research, the drugmaker emphasized that physicians should consider SGLT-2 inhibitors as a priority when choosing an additional treatment for type-2 diabetes patients because the treatments manage cardiovascular risk factors positively.

Several countries have changed or plan to change guidelines for diabetes treatments, based on the latest clinical data on SGLT-2 inhibitors’ impact on cardiovascular risk.

According to real-world data on clinical results of SGLT-2 inhibitors Jardiance, Forxiga, and Invokana (canagliflozin), the treatments lowered the risk of hospitalization due to heart failure by 39 percent, and the risk of death by 51 percent.

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