Positive effect of medication for diabetes on renal function can be applied directly in clinical practice

Certain glucose lowering drugs prescribed for patients with type 2 diabetes can markedly delay the progression of kidney function decline. A new class of glucose lowering drugs, so called sodium-glucose transporter (SGLT2)inhibitors, reduce the risks of dialysis by approximately 50% compared to commonly used glucose lowering drugs. Only half of the number of patients still needed dialysis compared with patients taking other medication designed to lower glucose levels. Previous studies had already shown this effect, but it now seems to be a direct and feasible option in clinical practice. The findings come from a large-scale international study headed by Professor of Clinical Pharmacology Hiddo Lambers Heerspink from the University Medical Center Groningen (UMCG). He analysed data from over 65,000 patients who had been prescribed medication for type 2 diabetes. The findings from his research have been published in the authoritative Lancet Diabetes & Endocrinology.

SGLT-2 inhibitors are prescribed for patients with type 2 diabetes. In the near future, they will also most likely be prescribed for patients with type 2 diabetes and reduced renal function. They will be prescribed for patients who have no other way of reducing their blood sugar levels. Some 40% of people with diabetes develop kidney disease. The aim of the study was to work out whether the use of SGLT-2 inhibitors in clinical practice would indeed slow down the deterioration of renal function. Lambers Heerspink worked together with researchers from Japan, Taiwan, Israel, Italy and Great Britain and used data from over 65,000 patients.

The research revealed that the SGLT-2 inhibitors clearly slowed down the deterioration of renal function. It also showed that the effect of SGLT-2 inhibitors is much more powerful than other diabetes medication. Only half of the number of patients still needed dialysis and the deterioration of renal function was twice as slow as in patients taking other medication. This vastly improves the quality of life of these patients.

According to Lambers Heerspink, the results of this research can be applied directly in clinical practice. ‘The medication has already been registered so it is now up to doctors to start prescribing it to their patients. The efficacy and safety of the drug have been demonstrated in several meticulous clinical trials and so it is now good-to-go in clinical practice. The international guidelines are currently being amended to recommend the use of this medication. The American and European kidney associations are also endorsing its use.’

Some 1.2 million people in the Netherlands have diabetes, with 1,200 new cases being diagnosed every month.

More information

• The article in Lancet Diabetes & Endocrinology