Side effects of SGLT-2 inhibitors

This review presents updated information on the side effects of sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors), the most modern group of hypoglycemic agents. In addition to their hypoglycemic action, SGLT-2 inhibitors exhibit secondary pharmacodynamics (side effects), providing cardioprotective, antiarrhythmic, anti-apoptotic, anti-inflammatory, nephroprotective, and neuroprotective effects, while reducing total body fat and visceral fat. The use of these side effects is desirable and promising for the treatment of patients with diabetes, especially in the presence of comorbidities. However, the use of SGLT-2 inhibitors may lead to undesirable reactions, the most common of which are dehydration (hypovolemia), glycosuria, and fungal infections of the genitalia and urinary tract. The most frequent serious outcomes of adverse reactions include euglycemic diabetic ketoacidosis, lower limb amputation, and acute kidney injury. Recommendations for the prevention of adverse reactions are presented.