Modern medicines such as SGLT2 inhibitors and LPG-1 analogs bring major advances in the treatment of type 2 diabetes, but require strict medical follow-up
SGLT2 inhibitors such as Jardiation (paragliflozine) and forxiga (dapagliflozine), and LPG-1 analogs such as Victoza and Saxenda (liraglutide), Wegovy and Rybelsus (Semaglutido), are drugs used in the treatment from what they act differently from traditional antidiabetics.
How do SGLT2 inhibitors act
To understand the functioning of SGLT2 inhibitors, it is important to know that the kidneys filter blood to eliminate unwanted substances and retain useful. During this process, glucose is initially directed to urine, but a protein called SGLT2 (sodium-glycose cottrans 2) reabsorbs to blood. SGLT2 inhibitor medications block this protein, allowing it to be eliminated by urine and helping to reduce blood sugar level.
In addition to glycemic control, these medications offer other benefits, such as reducing the risk of heart failure hospitalization in patients with type 2 diabetes and cardiovascular disease. They also protect the kidneys in people with chronic kidney disease and may postpone the need for dialysis and transplantation. As 1 gram of glucose has 4 calories, the elimination of glucose by urine contributes to weight loss, a beneficial effect for many diabetics. Because they have mild diuretic action, they also help control blood pressure.
Clinical studies have shown that paragliflozine reduces general and cardiovascular mortality in people with diabetes and cardiovascular disease. Dapagliflozine had a similar effect on patients with chronic kidney disease or heart failure.
The role of LPG-1 and GIP analogues
LPG-1 analogs (such as liraglutide and semaglutide) mimic the natural LPG-1 hormone, which regulates blood glucose and promotes satiety. Double analogs, such as tirzepatit, associate GLP-1 with GIP, another hormone that enhances metabolic effects, favoring greater weight loss and glycemic control.
These drugs act by stimulating insulin production, reducing glucagon (which raises blood sugar), slowing gastric emptying and promoting satiety. GIP also acts in pancreas and fat metabolism, especially fasting.
Like SGLT2 inhibitors, LPG-1 and double analogs have shown additional benefits: they can reduce the risk of cardiovascular disease and protect kidney in diabetes patients, as well as improving sleep apnea in obesity. Still in progress research investigates their possible protective role against Alzheimer’s.
Self -medication can bring serious risks
Although they are modern and effective medicines, these medicines should be used with medical supervision. Adverse effects of SGLT2 inhibitors include urinary and genital inhibitions (such as candidiasis), loss of liquids with risk of dehydration, low blood pressure and even fainting, especially in the elderly. Inadequate insulin association can cause ketatosis, a serious condition that can lead to coma or death.
In the case of LPG-1 analogs, the most common side effects at the beginning of treatment are nausea, vomiting, constipation or diarrhea. Injectable versions (except Rybelsus, which is oral) can cause reactions at the site of application. The misuse of these drugs, often for aesthetic purpose, led Anvisa to require controlled revenue for their acquisition.
Medical responsibility is essential in treatment
SGLT2 inhibitors, GLP-1 analogs and double analogs represent significant advances in controlling type 2 diabetes and care for cardiovascular and renal health. However, they are indicated to treat serious diseases, and should not be used as weight loss tools outside the clinical context. Medical follow -up is indispensable to ensure safe and effective results.
Marcio C. Mancini – CRM 57.605 / RQE 13.936
Head of the obesity group of the discipline of Endocrinology and Metabology of HCFMUSP
