SGLT2 Inhibitors May Result in Serious Side Effects
Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitors are prescribed by doctors to help patients with type 2 diabetes remove sugar from the body by way of the kidneys, thus helping manage their blood sugar levels. Untreated diabetes can lead to blindness, nerve and kidney damage, heart disease, and other serious complications, so keeping blood sugar levels under control is of tremendous importance; but treatment involving SGLT2 inhibitors is not without serious risks.
The SGLT2 inhibitors currently on the market— Invokana, Invokamet, Jardiance, Xigduo XR, Farxiga, and Glyxambi— are intended for patients to use in tandem with diet and exercise to achieve and maintain normal blood sugar levels. Though approved by the U.S. Food & Drug Administration (FDA), adverse events resulting from the use of SGLT2 inhibitors have been reported. Diabetic ketoacidosis, kidney failure, and heightened susceptibility to bone fractures and bone density loss are of primary concern with SGLT2 inhibitor use.
Side Effects of SGLT2 Inhibitors: Diabetic Ketoacidosis, Kidney Failure, Bone Loss and Fractures
After 20 cases of diabetic ketoacidosis were documented with the FDA Adverse Event Reports, the agency relayed warnings regarding the use of SGLT2 inhibitors. Diabetic ketoacidosis, which means there is too much acid in the blood, presents with symptoms that include difficulty breathing, nausea and vomiting, abdominal pain, unusual fatigue, and confusion. The condition may be life-threatening, as the body’s cells cannot access the sugar it must have for energy. When those sugars are unavailable, the body instead breaks down fat and muscle, which releases ketones—hence the build-up of acid in the blood. Diabetic ketoacidosis can be very serious and may result in coma, brain swelling, or death.
Another cause for concern when using SGLT2 inhibitors is the increased risk of kidney failure. Kidney failure may occur due to the strain put on the kidneys as the drugs eliminate the sugar through the kidneys and out with the urine. Though kidney failure may be initially asymptomatic, if not treated promptly, it can be progressive and ultimately fatal.
With regard to bone fractures, patients who were prescribed 300 mg of Invokana were almost 50% more likely to sustain a broken bone. Bone loss has been documented, with hip bone density declining by as much as 1.2% over two years and reduced femoral neck bone density.
Having issued warnings to help safeguard against these side effects, the FDA urges patients and medical professionals to report side effects linked to the use of SGLT2 inhibitors.
SGLT2 Inhibitors by Brand Name and Generic Name
- Invokana (canagliflozin);
- Invokamet (canagliflozin and metformin);
- Jardiance (empagliflozin);
- Xigduo XR (dapagliflozin and metformin);
- Farxiga (dapagliflozin); and
- Glyxambi (empagliflozin and linagliptin).
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