A Comparative Effectiveness & Renoprotective Effects of Hypoglycemic Drugs for Type 2 Diabetes Mellitus

Abstract

Type 2 Diabetes Mellitus (T2DM) is a huge burden on healthcare systems globally and it can lead to impaired kidney function, albuminuria, end-stage renal disease (ESRD). T2DM impact on the kidneys could results in diabetic nephropathy (DN) or diabetic kidney disease (DKD). It increases morbidity and mortality rate, therefore, decreases the quality of life.  Present treatment protocol relies on lowering glucose levels, and strict blood pressure control by targeting blockade of the renin–angiotensin–aldosterone system. Such approaches might slow-down the decline in kidney function but many patients get end-stage kidney failure, despite optimal therapy. The need for new pharmacologic strategies for T2DM, that could prevent the development of DN and safeguard the kidneys, is rising. In this article, an overview of recent clinical data pertaining to novel therapeutic approaches for the management of DN is provided. Moreover, this review evaluates comparative effectiveness of hypoglycemic drugs like sodium-glucose cotransporter-2 inhibitors (SGLT2-i), glucagon-like peptide-1 receptor agonists (GLP1-RA), dipeptidyl peptidase-4 inhibitors (DPP4-i), and finerenone in treating T2DM and their renoprotective effects. This manuscript also highlights the need for selecting suitable drugs for a patient, as the optimal treatment significantly depends upon the patient-specific conditions.