Les inhibiteurs de SGLT2 : pour quels patients ? Quelle place dans la stratégie thérapeutique ?

The treatment of type 2 diabetes benefits from different therapeutic classes. The older drugs are criticized in relation to their side effects, particularly the risk of hypoglycemia and weight gain. Soon, the new class of sodium-glucose cotransporter 2 (SGLT2) inhibitors will be launched on the market and will be used in the strategy of type 2 diabetes therapy. Its mode of action is specific, focused on renal effects, and as for those acting on the incretin axis has a very low rate of hypoglycemia, but furthermore a beneficial effect with a constant body weight loss. The question is raised on the positioning of these new drugs, the current therapeutic choice already allowing the individualization of treatment with multiple combinations. Current recommendations from the French Haute Autorité de la Santé (HAS), as well as those from European and American scientific societies have not yet decided on the positioning of this new therapeutic class. This review is intended to give some thinking on how we shall have to prescribe SGLT2 inhibitors in the broad context of marketing permissions obtained for these molecules, but certainly more limited from the French Transparency Commission and so these drugs'reimbursement.