Canagliflozin: Improving diabetes by making urine sweet

Abstract

Canagliflozin is the first sodium-glucose cotransport 2 (SGLT2) inhibitor approved in the United States for treating type 2 diabetes mellitus. This drug blocks reabsorption of glucose in the proximal tubule, lowering the renal threshold for glucose and thereby increasing glucose excretion. Its novel mechanism of action is insulin-independent. Trials have demonstrated reductions in fasting glucose and hemoglobin A1c levels, with the added benefit of weight loss. The adverse effects most often reported include genital yeast infections and urinary tract infections. Ongoing trials will further elucidate possible long-term risks of this drug.