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Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease, control of which typically requires multiple therapies. Current guidelines suggest that, in addition to improving glycemic control, antihyperglycemic therapy should be chosen on the basis of its effects on body weight and the risk of hypoglycemia. The newest class of oral antihyperglycemic agents, the sodium glucose cotransporter 2 (SGLT2) inhibitors, reduces renal glucose reabsorption and increases urinary glucose excretion via an insulin-independent mechanism of action. SGLT2 inhibitors have been shown to improve glycemic control and to reduce body weight and systolic blood pressure, and their use is associated with a low risk of hypoglycemia. This paper explains the mechanism of action of SGLT2 inhibitors and reviews published efficacy and safety data from phase 3 clinical trials and pooled analyses for the three SGLT2 inhibitors currently approved by the U.S. Food and Drug Administration for use in patients with T2DM: canagliflozin (Invokana®), dapagliflozin (Farxiga™), and empagliflozin (Jardiance®). Implications for clinical osteopathic practice are discussed.

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Originally published in Osteopathic Family Physician, 7(5), 10-30. © American College of Osteopathic Family Physicians. Reprinted with permission of the publisher. This material can be found here.