**7. Conclusion**

SGLT2-I are a unique emerging class of OAH agents that has addressed fundamental aspects of the unmet needs that challenge physicians treating T2DM patients, such as increased risk of hypoglycemia and weight gain that are usually noticed with other agents such as insulin. On the contrary, SGLT2-I therapy in T2DM is associated with very low risk of hypoglycemia and also promotes weight loss. Moreover, SGLT2-I have been shown to reduce the risk of MACE, all-cause mortality, and hospitalization for heart failure. They have additional renal protective properties besides reducing SBP. In fact, their mode of action through prevention of glucose reabsorption in the kidney makes them work independently from the pancreas, bypassing the problem of progressive beta cell failure that happens in most patients with T2DM over time, and this gives them longer durability. They can be used regardless of duration of disease and can be used as monotherapy as well as in combination as they have been shown to complement actions of other OAH agents including insulin. Considering their unique mechanism of action, they may be useful in impaired glucose tolerance and prediabetes also. The major side effects drawbacks of SGLT2-I is the increased rate of GMI. Another important side effect of SGLT2-I is EKA in T2DM patients during stress and following surgery as

**89**

**Author details**

Saudi Arabia

provided the original work is properly cited.

*SGLT2 Inhibitors Therapy in Type 2 Diabetes Mellitus DOI: http://dx.doi.org/10.5772/intechopen.84152*

dose with the least side effects.

received in any form for this work.

**Conflict of interest**

well as in T1DM, which is an off-label use of these medications and seems to be dose dependent. Future drug developments should focus on finding the least effective

Authors declare that there is no conflict of interest. No fund or grant was

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

Obesity Endocrine and Metabolism Center, King Fahad Medical City, Riyadh,

Maswood M. Ahmad\*, Imad Addin Brema and Mussa H. Almalki

\*Address all correspondence to: saadmaswood@gmail.com

well as in T1DM, which is an off-label use of these medications and seems to be dose dependent. Future drug developments should focus on finding the least effective dose with the least side effects.
