Effets indésirables et sécurité d'emploi des inhibiteurs des SGLT2

SGLT2 inhibitors are globally well tolerated but their mode of action results in specific side effects. An increased risk of genital infections (vulvo-vaginitis et balanitis) and of urinary tract infections, already high in type 2 diabetic subjects, has been reported during the first six months of treatment with these molecules. However, these infectious events respond to standard treatment and recur infrequently. Side effects induced by the initial volume depletion are also observed in some cases, mainly in the elderly or in subjects with moderate renal failure and/or receiving loop diuretics. This new therapeutic class does not increase the incidence of hypoglycaemia with the exception of combination therapies with insulin secretagogues or insulin therapy. Finally, large interventional trials are ongoing with the aim to precise the safety of these molecules in the long term, especially regarding cardiovascular events.