Potential molecular mechanism of action of sodium-glucose co-transporter 2 inhibitors in the prevention and management of diabetic retinopathy

EXPERT REVIEW OF OPHTHALMOLOGY(2022)

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Abstract
Introduction:Sodium glucose co-transporter 2 (SGLT2) inhibitors are a new class of drugs for the treatment of type 2 diabetes mellitus (T2DM), which have cardio-renal protective activity. Some studies have also found that this drug may have an eye-protective effect, especially in preventing diabetic retinopathy (DR). Areas covered:A search was conducted on PubMed and Google Scholar for all articles published from January 2007 to May 2022. This paper provides a new insight into how new emerging diabetic therapy may be beneficial in the case of DR. SGLT2 inhibitors have been proven to delay DR progression. However, the drug mechanism in the pathophysiology of diabetic retinopathy has not yet been established. Expert opinion:In clinical practice, using SGLT2 inhibitors is beneficial as it offers multiple advantages. They can control blood sugar levels while simultaneously suppressing the progression of DR and DME. There is potential that the use of other expensive and prolonged therapeutic modalities may no longer be necessary, reducing the burden of treatment for patients.
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Key words
Diabetic retinopathy, sodium-glucose co-transporter 2 inhibitors, pericyte damage, mTOR pathway, polyol pathway, SIRT, AMPK pathway, oxidative stress
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