New diabetes drug possibly protects the kidneys

A new type of drug for treating type 2 diabetes does not only lower blood sugar levels, but also helps to protect the kidneys. This is the conclusion of a research group headed by clinical pharmacologist Hiddo Lambers Heerspink from the UMCG. The research findings will be published online today in Journal of the America Society of Nephrology (JASN).

Patients with type 2 diabetes are prone to high blood sugar levels and have a heightened risk of hypertension, weight gain and kidney damage. As a result, research focuses on designing drugs that will reduce blood sugar levels. Until now, metformin was the drug most commonly prescribed, followed by a sulfonylurea derivative such as glimepiride or gliclazide, which stimulates the pancreas to produce insulin. A new drug has now been developed: canagliflozin. This drug inhibits the sodium-glucose cotransporter 2 (SGLT2) in the kidneys but until now, its effect on kidney function had not been properly investigated.

1,450 patients for two years

Heerspink compared the effects of these two drugs with each other in terms of weight, blood sugar level and kidney function. He used data from 1,450 type 2 diabetes patients from 19 countries, all of whom were taking metformin, the current standard treatment for type 2 diabetes. Some of them were prescribed glimepiride in addition to metformin, while others were also given canagliflozin 100 mg or canagliflozin 300 mg in addition to metformin. For a period of two years, the weight, blood sugar level and kidney function of these patients was regularly monitored.

Kidney protection

Heerspink concludes that both drugs have roughly the same effect in terms of reducing the blood sugar level. However, kidney function deteriorates less quickly in patients taking canagliflozin. So canagliflozin appears to protect the kidneys. ‘As the effect on the blood sugar level was much the same for both drugs, our results suggest that the protective effect on the kidneys is not connected with a lower blood sugar level,’ says Heerspink. ‘These results are particularly important because many diabetes patients are at risk of kidney failure. Canagliflozin might prove to be a good therapeutic alternative for these patients.’

Clinical trials

Canagliflozin is already on the market in Europe and America. ‘We need larger trials with longer follow-up periods before we can be certain that this drug is preferable to glimepiride when treating kidney failure. This is currently work in progress.’

Source: news release UMCG