Gabbai FB, Romero BJE

Idioma: Español
Referencias bibliográficas: 35
Paginas: 60-67
Archivo PDF: 142.52 Kb.

RESUMEN

Los inhibidores del cotransportador sodio-glucosa 2 (SGLT2) representan una nueva modalidad de tratamiento para los pacientes con diabetes mellitus. Estos agentes bloquean el mecanismo más importante para la reabsorción de glucosa a nivel renal, promoviendo la pérdida de grandes cantidades de glucosa en orina. La diuresis osmótica asociada a estos agentes conduce a un aumento del hematocrito, un descenso de la presión arterial sistólica y diastólica, y la pérdida de peso. Estudios a largo plazo (EMPA-REG, CANVAS) han mostrado que estos fármacos reducen el riesgo relativo de complicaciones cardiovasculares (muerte por causa cardiovascular, infarto del miocardio no letal, accidente vascular cerebral, hospitalización por insuficiencia cardiaca), así como de complicaciones renales (aumento de la proteinuria, progresión de la enfermedad renal, nefropatía de reciente inicio). Su uso se asocia a aumento en la frecuencia de infecciones tanto bacterianas como micóticas del tracto genitourinario, y con uno de ellos (canagliflozina) existe un posible aumento en el número de amputaciones y fracturas. Estos medicamentos no producen hipoglucemia, pero se han reportado casos de cetoacidosis. El perfil y las características de los inhibidores del SGLT2 constituyen, sin duda alguna, beneficios importantes para el manejo y supervivencia de los pacientes diabéticos.

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