Tell me about SGLT2 inhibitors

[bill hopkinson]

Can anyone tell me anything about SGLT2 inhibitors?
Such as:
Dapagliflozin (Forxiga)
Canagliflozin (Invokana)
Empagliflozin (Jardiance)

I have a choice to make before my Saturday afternoon appointment:

1. Start using insulin
2. Drop glicazide and use an SGLT2 inhibitor instead.

The side effect to take into account is that urinary tract infections are common because SGLT2 inhibitors work by excreting sugar. More common in women than men, and less common in people with a high water intake like me, over 3 litres a day.

Earlier in the week I was thinking that insulin would give me direct control and eliminate some of the problems of inpredictably fluctuating sugar levels. Now I am leaning more towards giving the new drug a trial of six months, and if it doesn't do the job, then go on to insulin.

 

[Northerner]

What would be the downsides for you if you opted for insulin, Bill? I don't have any experience of these drugs since I have always been on insulin since diagnosis, but my personal feeling is that the mechanism of injected insulin is more 'natural' and doesn't mess with my body chemistry the way a drug is designed to do. Insulin does give you tight control (if you are on a basal/bolus regime - a fast for meals and a slow for background), so you can react and adjust for unexpected highs, and maybe also have more choice and flexibility with your diet.

But as you say, perhaps giving the drug six months to assess its impact would be a good idea as it will mean you can avoid the messing about and potential hypoglycaemia of insulin - if it works, fine, but if not then you still have the insulin option 🙂

 

[bill hopkinson]

What would be the downsides for you if you opted for insulin, Bill?

The downside of insulin is

• needle phobia
• one more thing to think about when travelling
• DVLA
• higher insurance

A positive of SGLT2 inhibitors is that they help to reduce weight, which insulin does not, so far as I know.

 

[Old Holborn]

I've been on Dapagliflozin (Forxiga) for the last 28 days with no side effects........yet.

 

[trophywench]

Well doesn't excreting glucose all the while just cause damage to your kidneys? hence why UTIs are more common ?

 

[reedtown1]

im on dapagliflozin for past 3 months now ,along with other drugs ,no side effects from it so far ,it has reduced my blod pressure a little bit as well as my bgs . I don't know if it will be sufficient for you ,it all depends on how high your bgs are and what other meds you are on , people do say there are side effects like infections ,kidney disease ,bladder cancer etc but I am been closely monitored for any such events.
I would say give it a go before you go for insulin..feel free to ask me any questions about it