FDA Approves Novel Diabetes Drug

By Kristin J. Kelley

The FDA has approved the first oral inhibitor of sodium glucose cotransporter 2 (SGLT2) to treat adults with type 2 diabetes. Canagliflozin (Invokana) lowers blood sugar by blocking the kidneys' urinary reabsorption of glucose, resulting in increased urinary excretion.

In nine studies comprising over 10,000 patients, the SGLT2 inhibitor improved hemoglobin A1c levels and blood sugar levels. Canagliflozin has been studied as a stand-alone treatment and in combination with metformin, sulfonylurea, pioglitazone, and insulin.

Common side effects include urinary tract infection and vaginal yeast infection. Dizziness or fainting could occur during the first 3 months of treatment due to the tablet's diuretic effect, which can lead to orthostatic or postural hypotension. The drug should not be used in patients with type 1 diabetes, diabetic ketoacidosis, severe renal impairment, or end stage renal disease.