Le rôle du rein dans l'homéostasie du glucose

In type 2 diabetics (T2D), renal gluconeogenesis and glucose utilisation are increased by 30%. Surprisingly, renal glucose reabsorption is increased, participating to worsening of hyperglycemia. This results from the increase in the renal threshold of glucose reabsorption (220 mg/dl) and from an overexpression of SGLT2 in response to hyperglycemia and of cytokine secretion. The administration of SGLT2 inhibitors to T2D patients induced a decreased in the renal threshold of glucose reabsorption (80 mg/dl) and strongly reduced kidney glucose reabsorption. The inhibitors of SGLT2 are the only antidiabetic molecules able to correct the excessive renal glucose reabsorption in T2D patients and thus to contribute, by an original mechanism to the lowering of blood glucose level.