The Role of Kidney in Glucose Homeostasis — SGLT2 Inhibitors, a New Approach in Diabetes Treatment

Vasileios Andrianesis; John Doupis


Expert Rev Clin Pharmacol. 2013;6(5):519-539. 

In This Article

Renal Gluconeogenesis in Diabetes

The importance of renal contribution to endogenous glucose release in types 1 and 2 diabetes is well established. Increased renal gluconeogenicenzyme and glucose-6-phosphatase activity have already been demonstrated in animal studies.[15–17] In only two human studies, it has been reported that renal and hepatic glucose release was increased by about the same degree in diabetic subjects.[18,19] The role of renal gluconeogenic activity is crucial during ketoacidosis because depressed pH impairs hepatic and enhances renal gluconeogenesis. Consequently, accelerating gluconeogenesis and glucose levels elevation observed during ketoacidosis can be mainly attributed to the kidney.[20]