The promise of SGLT2 inhibitors
Most drugs get approved to do one thing. In rare cases, drugs get multiple indications, allowing their manufacturers to advertise them as treatments for a range of conditions. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, also called flozins, began as diabetes drugs. Surprisingly, they turned out to also be very effective at improving heart health. Then they were discovered to slow the progression of chronic kidney disease, one of the leading causes of death and disability worldwide. Preliminary evidence indicates that they show promise in helping several other conditions, but no one knows exactly how they achieve this yet. Could SGLT2 inhibitors be a new medical Swiss Army knife?
SGLT2 is a protein found in the kidneys that stops the body from wasting calories. It works like a pump that extracts glucose from urine and moves it back into the blood. The sodium in the name refers to how that pump is powered: like a water wheel using a gradient in water height to move machinery, SGLT2 uses the gradient in sodium concentration between the urine and the blood as an energy source.
Phlorizin was the first drug that blocks SGLT2 to be isolated, in 1835. This compound was extracted from the root bark of the apple tree by French chemists and studied in the hopes that it would be useful for stopping fevers. It wasn’t.
