SGLT2 inhibitors, or sodium-glucose co-transporter 2 inhibitors, are a class of medications primarily used to manage type 2 diabetes by lowering blood glucose levels. They work by targeting the kidneys, where SGLT2 proteins are responsible for reabsorbing about 90% of the glucose filtered from the blood in the glomerulus back into the bloodstream. Here’s a concise explanation of their mechanism:

1. Blocking Glucose Reabsorption: SGLT2 inhibitors block the SGLT2 proteins in the proximal tubules of the kidneys. This prevents the reabsorption of glucose from the filtered urine back into the blood.
2. Increased Glucose Excretion: As a result, more glucose is excreted in the urine (a process called glucosuria), which lowers blood glucose levels independently of insulin action.
3. Additional Benefits: Beyond glucose control, SGLT2 inhibitors promote weight loss (due to calorie loss from glucose excretion), reduce blood pressure (via mild diuretic effects), and have shown cardiovascular and kidney protective effects in clinical trials, particularly in patients with heart failure or chronic kidney disease.
4. Mechanism Independence: Unlike insulin-dependent therapies, SGLT2 inhibitors work without relying on pancreatic beta-cell function, making them effective even in patients with reduced insulin production or insulin resistance.

Common SGLT2 inhibitors include empagliflozin (Jardiance), dapagliflozin (Farxiga), and canagliflozin (Invokana). They are typically used alongside lifestyle changes or other diabetes medications but may increase the risk of urinary tract infections, dehydration, or ketoacidosis in some cases.