I have type 2 diabetes. Are SGLT2 and GLP-1 drugs effective?

Hello,

Welcome to icliniq.com.

I understand your concern and am sorry for the uncontrolled diabetes you are facing.

Having high blood sugar levels and an HbA1c (glycated hemoglobin) of 8.7 % indeed puts you at a high risk for complications such as neuropathy (tingling in your feet) and retinopathy (blurred vision).

You should have these evaluated by a neurologist and an ophthalmologist, respectively.

SGLT2 (sodium-glucose cotransporter-2) inhibitors include Empagliflozin and Dapagliflozin. They work by increasing glucose excretion through the urine, thereby lowering blood sugar independently of insulin. This may also lead to mild weight loss and lower blood pressure.

The benefits beyond glucose control include kidney protection by slowing the progression of diabetic kidney disease, even in cases of mild impairment, and heart protection by reducing the risk of heart failure and major cardiovascular events.

Some main risks include the following:

1. Urinary or genital infections (such as yeast infections and UTIs (urinary tract infections)).

2. Volume depletion or low blood pressure (especially if you are on diuretics).

3. In rare cases, diabetic ketoacidosis occurs, mostly in patients with type 1 diabetes or those who are very insulin-deficient.

Since mild kidney changes may be present, kidney function should be monitored. Most SGLT2 inhibitors can be used if the eGFR is greater than 30 to 45 mL/min/1.73 m² (milliliters per minute per 1.73 meters squared).

GLP-1 (Glucagon-like peptide-1) receptor agonists include Semaglutide and Dulaglutide. They work by mimicking incretin hormones to increase insulin secretion and decrease glucagon in a glucose-dependent manner. By slowing gastric emptying, they reduce appetite and promote weight loss.

Benefits beyond glucose control include significant weight loss, an improved metabolic profile, cardiovascular protection with a reduction in major cardiac events in high-risk patients, and possible early kidney protection suggested by some studies.

Potential risks of GLP-1 receptor agonists include gastrointestinal symptoms such as nausea, vomiting, and diarrhea, and, in rare cases, pancreatitis (inflammation of the pancreas).

Combination therapy is often used if one medication is not sufficient. Monitoring should include kidney function, blood pressure, foot examinations, and regular eye checks.

I hope this answers your questions. Please let me know if you have any other concerns.

Thank you.