Background
hypoglycemia, diabetic complications
HYPOGLYCEMIA, DIABETIC COMPLICATIONS
Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose by promoting urinary glucose excretion in an insulin-independent manner. Hence, SGLT2 inhibitors are associated with a lower risk of hypoglycemia than conventional anti-diabetic agents. SGLT2 inhibitors also have pleiotropic effects, such as reducing body weight [Tofogliflozin is an SGLT2 inhibitor with high selectivity for SGLT2. Suzuki et al. measured the sodium-dependent glucose uptake in SGLT2-overexpressing cells and evaluated SGLT2 selectivity against SGLT1, expressed as the ratio of inhibitory concentration 50 (IC50) for each compound. Their study showed that tofogliflozin (2900-fold) was highly selective compared to dapagliflozin (610-fold), canagliflozin (290-fold), ipragliflozin (860-fold), empagliflozin (1100-fold), and luseogliflozin (1600-fold) [In several long-term observational follow-up studies after randomized controlled trials (RCTs) of anti-diabetic agents, it has been shown that emergent risk reductions for diabetic complications were observed during the post-trial follow-up period, highlighting the benefits of early and intensive glycemic control [