Thiazolidendiones SGLT2 inhibitors

Thiazolidendiones SGLT2 inhibitors

A Amouzegar MD

Endocrine Research Center, Research Institute For Endocrine Sciences, Shahid Beheshti University

Outlines:

• Mechanism of action of TZDs
• Efficacy of TZDs
• Safety of TZDs
• CVDs
• Osteoporosis
• Cancers
• SGLT2 inhibitors
• Thiazolidinediones, which are selective ligands of the nuclear transcription factor peroxisome-proliferator–activated receptor(PPAR-gamma)
• PPAR-gamma is expressed most abundantly in adipose tissue but is also found in pancreatic beta cells, vascular endothelium, and macrophages, muscles, liver

enhancement of insulin sensitivity:

• Thiazolidinediones consistently lower fasting and postprandial glucose concentrations as well as free fatty acid concentrations in clinical studies
• These indicate that thiazolidinediones act as insulin sensitizers, increases insulin-stimulated glucose uptake in peripheral tissues
• Thiazolidinediones increase hepatic insulin sensitivity (the ability of insulin to suppress endogenous glucose production) and insulin sensitivity  in adipose tissue (measured from the ability of insulin to suppress free fatty acid concentrations)