SGLT2

Class

Sodium-glucose cotransporter-2 inhibitor

Sodium-glucose cotransporter-2 (SGLT2) is a membrane protein located in the early proximal tubule of the kidney, where it reabsorbs the majority of glucose filtered from the blood back into the body, working alongside sodium. Under normal conditions this conserves glucose as an energy source, but in diabetes it also contributes to sustained high blood glucose by returning filtered sugar to circulation rather than allowing its excretion. Small-molecule inhibitors of SGLT2 block this reabsorption, causing excess glucose to be excreted in urine and thereby lowering blood glucose independent of insulin secretion or action. Because the transporter also reabsorbs sodium, its inhibition produces mild diuretic and natriuretic (sodium-excreting) effects, which lower blood pressure and reduce fluid overload. These combined glucose-lowering and fluid-modulating actions have made this mechanism broadly relevant not only in type 2 diabetes but also in chronic kidney disease and heart failure, conditions in which excess fluid retention and metabolic strain on the heart and kidneys are central problems. The insulin-independent mode of action is a key rationale for its use across a range of glycemic control needs and comorbidities, distinguishing it from older diabetes therapies that rely on stimulating or sensitizing insulin pathways.