- Type 2 Diabetes: Learn the Warning Signs
- Diabetes Friendly Dining
- Type 2 Diabetes: Test Your Medical IQ
- What are SGLT2 inhibitors?
- How do SGLT2 inhibitors work?
- What are the uses for SGLT2 inhibitors?
- What are the side effects of SGLT2 inhibitors?
- What are the dosages for SGLT2 inhibitors?
- Which drugs or supplements interact with SGLT2 inhibitors?
- Are SGLT2 inhibitors safe to take during pregnancy or while breastfeeding?
What are SGLT2 inhibitors?
SGLT2 (sodium-glucose co-transporter 2) inhibitors are prescription oral medications used to treat type 2 diabetes.
What generic and brand names of SGLT2 inhibitors are available in the US?
Brand and generic names of SGLT2 inhibitors and combination products that contain SGLT2 inhibitors include:
- canagliflozin (Invokana)
- canagliflozin/metformin (Invokamet)
- canagliflozin/metformin extended release (Invokamet XR)
- dapagliflozin (Farxiga)
- dapagliflozin/metformin extended release (Xigduo XR)
- dapagliflozin/saxagliptin (Qtern)
- empagliflozin (Jardiance)
- empagliflozin/linagliptin (Glyxambi)
- empagliflozin/metformin (Synjardy)
- empagliflozin/metformin extended release (Synjardy XR)
- ertugliflozin (Steglatro)
- ertugliflozin/metformin (Segluromet)
- ertugliflozin/sitagliptin (Steglujan)
Do I need a prescription for SGLT2 inhibitors?
How do SGLT2 inhibitors work?
- SGLT2 inhibitors reduce blood glucose by blocking the action of a protein called sodium-glucose co-transporter-2 (SGLT2) in the kidney. This protein is responsible for reabsorbing sugar back into the body from urine. Blocking this protein prevents the kidney from reabsorbing glucose from urine and causes glucose to be removed from the body through urine. This lowers the level of glucose in the blood.
- SGLT2 inhibitors also reduce blood pressure and cause weight loss. In one study, empagliflozin (Jardiance) significantly reduced the risk of death from cardiovascular causes, death from any cause, and the risk of hospitalization for heart failure in people with type 2 diabetes.
- The FDA approved the first SGLT2 inhibitor, canagliflozin (Invokana), in 2013.
What are the uses for SGLT2 inhibitors?
- SGLT2 inhibitors are used alone or in combination with metformin or other diabetic medications and with exercise and diet to reduce blood glucose in adults with type 2 diabetes.
- SGLT2 inhibitors are not for treating people with type 1 diabetes or for treating diabetic ketoacidosis.
- SGLT2 inhibitors are not prescribed for patients with kidney disease including those on dialysis.
Latest Diabetes News
Daily Health News
What are the side effects of SGLT2 inhibitors?
On Aug. 29, 2018, the FDA issued a warning that cases of a rare but serious infection of the genitals and area around the genitals have been reported with the class of type 2 diabetes medicines called SGLT2 inhibitors. This serious rare infection, called necrotizing fasciitis of the perineum, is also referred to as Fournier’s gangrene.
SGLT2 inhibitors are FDA-approved for use with diet and exercise to lower blood sugar in adults with type 2 diabetes. SGLT2 inhibitors lower blood sugar by causing the kidneys to remove sugar from the body through the urine. First approved in 2013, medicines in the SGLT2 inhibitor class include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. In addition, empagliflozin is approved to lower the risk of death from heart attack and stroke in adults with type 2 diabetes and heart disease. Untreated, type 2 diabetes can lead to serious problems, including blindness, nerve and kidney damage, and heart disease.
Seek medical attention immediately if you experience any symptoms of tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell. These symptoms can worsen quickly, so it is important to seek treatment right away.
On May 15, 2015, the FDA informed the public that SGLT2 inhibitors have been associated with increased risk of ketoacidosis in people with diabetes.
Common side effects
The most common side effect of SGLT2 inhibitors include:
- Genital yeast infections in men and women
- Urinary tract infections (UTIs)
- Increased urination
- Kidney problems
- Flu like symptoms
- Nasal congestion
- Urinary discomfort
- Back pain
Serious side effects of SGLT2 inhibitors include:
- Kidney failure
- Hyperkalemia (high levels of potassium in the blood)
- Hypotension (low blood pressure)
- Increased cholesterol levels
- Serious urinary tract infections
- Increased bladder cancer risk
- Serious allergic reactions
- Low blood glucose (hypoglycemia) when combined with insulin or drugs that increase insulin production
What are the dosages for SGLT2 inhibitors?
SGLT2 inhibitors are available as tablets.
- canagliflozin (Invokana): 100, 300 mg tablets
- dapagliflozin (Farxiga): 5, 10 mg tablets
- empagliflozin (Jardiance): 10, 25 mg tablets
Which drugs or supplements interact with SGLT2 inhibitors?
- Combining SGLT2 inhibitors with insulin or drugs that increase insulin secretion increases the risk of hypoglycemia.
- Combining SGLT2 inhibitors with diuretics increases the frequency of urination and the risk of dehydration.
- Rifampin, phenytoin, phenobarbital, ritonavir (Norvir) increase the removal of canagliflozin from the body by increasing the action of UDP glucuronosyl transferases (UGT) enzymes. UGT are enzymes that convert chemicals in the body to other types of chemicals that dissolve better in water and are easier to remove from the body. This interaction may reduce the efficacy of canagliflozin. Therefore, the dose of canagliflozin may need to be increased when it is combined with drugs that increase its removal form the body.
- Canagliflozin increases blood levels and the effect of digoxin.
- The prescribing information for dapagliflozin does not list any drug interactions.
Are SGLT2 inhibitors safe to take during pregnancy or while breastfeeding?
SGLT2 inhibitors have not been adequately evaluated in pregnant women. SGLT2 inhibitors affected kidney development and maturation in animals.
SGLT2 (sodium-glucose co-transporter 2) inhibitors is a class of drugs prescribed to treat type 2 diabetes in conjunction with diet and exercise. Review side effects, drug interactions, preparations, and pregnancy and breastfeeding safety information prior to taking any medication.
Multimedia: Slideshows, Images & Quizzes
Type 2 Diabetes: Signs, Symptoms, Treatments
Learn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Find out why thirst, headaches, and...
Diabetes: What Raises and Lowers Your Blood Sugar Level?
Want to lower your blood sugar? Learn to better control your glucose levels by preventing blood sugar spikes and swings to avoid...
How Diabetes Can Affect Your Feet
Learn more about diabetes related foot problems. For people with diabetes, too much glucose in the blood can cause serious foot...
Exercise and Fitness: 10 Budget-Friendly Exercise Gadgets
There are plenty of cheap and free ways to exercise. Learn about inexpensive ways to get in shape with the use of jump ropes,...
The Best Diet Tips: How to Lose Weight the Healthy Way
Learn to lose weight in a realistic way that works. Find healthy weight loss by eating right, sleeping more, understanding...
Diabetes Nerve Pain: Improving Diabetic Peripheral Neuropathy
Learn how to cope with the symptoms of diabetic peripheral neuropathy through pain management exercises. Find relief for diabetic...
Grocery Smarts: Right vs. Wrong Food Choices at the Supermarket
Grocery shopping means choosing the right foods and avoiding the wrong ones for a healthy diet. Low-fat snack ideas include...
Healthy Seeds: 11 Edible Super Seeds for Better Nutrition
Are pumpkin seeds good for your health? What's the nutritional value of chia seeds? Find out how to easily incorporate more...
Diabetes Travel: Tips for Better Diabetes Control
Diabetes shouldn't stop you from traveling! Learn tips for packing diabetic supplies, controlling blood sugar while changing time...
Popular Dieting Myths and Facts
Can't tell fact from fiction about weight loss and healthy eating? Discover the truth behind some of the most common diet and...
Diet Mistake Pictures: Crash Diets, High-Calorie Drinks, and More
Discover 10 common diet mistakes that may be preventing you from losing weight. Learn to avoid these diet blunders and watch the...
Food Swaps for Meals and Snacks for Heart Health in Pictures
Explore 10 food swaps for heart-wise dining. Learn what food to buy and how to cook in order to make a big difference for your...
Diet-Wrecking Foods: Smoothies, Lattes, Popcorn, and More in Pictures
It may seem healthy, but is it really? Many food frauds masquerade as diet food. See 23 foods that seem healthy but can be...
Diabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Discover the best and worst meals for diabetes-savvy dining. See how to avoid carbs and control your blood sugar with healthier...
Pictures of the 7 Most Effective Exercises to Do at the Gym or Home (and Tips to Improve Form)
These seven exercises deliver fitness results at home or in the gym. Start your training to better physical health with the most...
Food Cravings Slideshow: Chocolate, Carbs, Salt, Sugar
Learn which food cravings can wreck your diet. Whether your craving something creamy or crunchy, sweet or salty, food cravings...
Salt & Low Sodium Diet Quiz
Do you love salt? Take the online Salt Quiz to get the facts about dietary salts and sodium in fruits, vegetables, processed...
Pictures of the 7 Riskiest Workout Moves, and How to Improve Them
Working out is supposed to make you healthier--but some exercises can leave your body at risk of pain or injury. Some exercises...
Diet and Nutrition Quiz: Plans & Facts
Even if you think you're getting enough fruits and vegetables per day, how can you be sure? Take the Diet & Nutrition Quiz to...
Sugar Quiz: Facts on Diet & Sugar
Sugar lurks in surprising places. Take the Sugar Quiz to learn of the many ways sugar sneaks into your diet and see what you know...
Type 2 Diabetes: Test Your Medical IQ
What causes type 2 diabetes? Can it be prevented? Take this online quiz and challenge your knowledge of this common condition....
Diabetes Quiz: Test Your Medical IQ
Take the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do...
Exercise and Fitness Quiz: Test Your IQ
Take our Exercise and Fitness Quiz and learn to maximize your fitness level with simple exercises that do not require major...
High Protein Diets: Good or Bad?
Can a high protein diet help you lose weight fast and help you feel full? High-protein diets are popular, but is there a down...
Portion Control: Plate Photos to Lose Weight, Maintain Diet
Portion control can help with weight loss. The right plate amount can help you stick to a healthy diet. Learn to lose weight with...
No-Gym Workout in Pictures: Equipment, Routines, and More
Learn about this no-gym, at home quick workout. It can get you into great shape at home and shows the best moves for flat abs and...
Diet for Stress Management: Carbs, Nuts, and Other Stress-Relief Foods
While there are many ways to cope with stress, one strategy is to eat stress-fighting foods. Find out which foods to eat as part...
Slideshow: Diabetes Management in 10 Minutes
Learn 10 simple ways to better manage your diabetes. See tips for controlling blood sugar, diet and exercise and other helpful...
Diabetes: 15 Famous Celebrities With Diabetes
See pictures of celebrities that have been diagnosed with type 1 or type 2 diabetes including Mary Tyler Moore, Salma Hayek, and...
Vegetarian Diet: Benefits, Meat Substitutions, and Meal Plans
Vegetarian diet plans have benefits like weight loss and reduced risk of heart disease, diabetes, and cancer. Vegetarian diet...
12 Reasons to Love the Mediterranean Diet
The Mediterranean diet is a delicious way to eat healthy. We show you how to get the most from this diet with foods like olive...
The 30-Minute Fitness Routine in Pictures
This quick, high-intensity 30-minute workout routine can make you look better and feel better. Discover the right way to do...
Diabetes Diet: 11 Low-Sugar Drink Ideas
Searching for low-sugar drink ideas? This pictures slideshow has eleven beverages ideal for people with diabetes and those...
10 Muscle-Building Exercises for Diabetes
Watch this slideshow on Diabetes and Exercise. If you have diabetes, see how strengthening your muscles with these 10 weight...
Healthy Fast Food Options: 10 Tips for a Weight Loss Diet
What healthy fast food options are around you? Most fast food can't compare to the health of a well-planned, balanced diet. But...
Exercise Tips for Kids and the Whole Family
Exercise is great for kids, and fun activities for the whole family are there if you know how to find them. Learn how to lose...
17 Must-Try Fitness Workouts in Pictures
Learn the latest exercise crazes such as TRX, pole dancing, Zumba, Kangoo jumps, boot camps, exergames and more that are designed...
Benefits of Exercise: Fitness Facts Prove the Benefits of Working Out
The best way to lose weight? These fast facts show weight loss is possible for everyone trying to lose weight. From calories to...
Tips to Eat Healthy When You Dine Out in Pictures
Recognize the dangers of eating out and stay on your healthy diet at restaurants. Learn about healthy eating at restaurants,...
Related Disease Conditions
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Type 2 Diabetes Diet Plan
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
Low Blood Sugar (Hypoglycemia)
Low blood sugar or hypoglycemia occurs when blood sugar is dangerously low and is often complication of type 1 and type 2 diabetes. Learn about symptoms, dangers, and treatment.
High Blood Sugar (Hyperglycemia)
Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms of high blood sugar may include increased thirst, headaches, blurred vision, and frequent urination.Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
Which is Worse - Type 1 or Type 2 Diabetes?
Learn about the similarities and differences between Type 1 and Type 2 Diabetes.
Type 2 Diabetes
Type 2 diabetes is a chronic condition that may be reversible with diet and lifestyle changes. Symptoms include excessive thirst, frequent urination, weight loss, fatigue, and an unusual odor to your urine. Most people don't know they have type 2 diabetes until they have a routine blood test. Treatment options include medications, a type 2 diabetes diet, and other lifestyle changes.
Diabetic Ketoacidosis (Causes, Symptoms, Treatment, Complications)
Diabetic ketoacidosis (DKA) is a complication of type 1 diabetes that is life threatening. If a person thinks they may have diabetic ketoacidosis they should seek medical care immediately. Diabetic ketoacidosis happens when a person's insulin levels in the blood become dangerously low. Symptoms of diabetic ketoacidosis include dehydration, abdominal pain, confusion, and nausea and vomiting. Diabetic ketoacidosis needs medical treatment. It cannot be treated at home.
Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Types of Diabetes Type 2 Medications
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and exercise. There are nine classes of drugs approved for the treatment of type 2 diabetes. Examples of type 2 oral diabetes medications include acarbose (Precose), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), and metformin (Glucophage). Side effects, drug interactions, warnings and precautions, dosage, and breastfeeding and pregnancy safety information should be reviewed prior to taking any medication.
A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may also help stabilize blood glucose levels. Keeping track of when you take your diabetic medicine, keeping track of food choices, eating the proper amount of fruits, vegetables, carbohydrates, and fats will also help maintain proper blood glucose levels.
Diabetes Foot Problems
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
What Is Diabetic Neuropathy?
Diabetic neuropathy a condition in which nerve damage has occurred as a complication of diabetes. The pain from the nerve damage can be severe with tingling or numbness in the part of the body affected. Diabetic neuropathy can occur anywhere in the body. Diabetic neuropathy can cause symptoms like intense pain, numbness, burning, or tingling in the part of the body affected by the condition. There are four types of neuropathy include peripheral, autonomic, proximal and focal. Natural therapies and medications may help relieve the pain and other symptoms of diabetic neuropathy.
Eye Problems and Diabetes
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
Can Type 1 Diabetes be Cured?
Type 1 diabetes is a disorder of the pancreas. The organ doesn't make enough insulin. Learn what medical treatments can help ease your type 1 diabetes symptoms and speed up your recovery.
Diabetes and Kidney Disease
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
Sex, Urinary, and Bladder Problems of Diabetes
Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
Diabetes: Caring for Your Diabetes at Special Times
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in situations such as illness, work, school, travel, or a natural disaster.
Treatment & Diagnosis
Medications & Supplements
Prevention & Wellness
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
U.S. Food and Drug Administration. "FDA approves Invokana to treat type 2 diabetes First in a new class of diabetes drugs."
U.S. Food and Drug Administration. "FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes."
Zinman, B. et al. "Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes — NEJM." New England Journal of Medicine. N.p., 17 Sept. 2015. Web. 27 Apr. 2016.