An abnormally high level of sugar in your urine has traditionally been a sign of uncontrolled diabetes and something to be corrected. But that notion has been turned on its head by a new class of diabetes drugs that work by increasing how much sugar patients pass in their urine. To date, two of these new drugs have been approved by the U. Food and Drug Administration for treating type 2 diabetes. The first, canagliflozin (Invokana®), was cleared last March; the second, dapagliflozin (Farxiga®), was approved just this week. Both drugs are so-called SGLT2 inhibitors that act by blocking the kidneys’ reabsorption of sugar, or glucose. The result is that more glucose is released in the urine and the patient’s blood glucose level goes down — a major goal of diabetes treatment. Most other available drugs for diabetes work by targeting the liver, pancreas or gut to improve insulin sensitivity, reduce insulin resistance or stimulate insulin secretion. For many people with diabetes, metformin comes first. The American Diabetes Association (ADA) recommends that doctors prescribe this medication to their newly diagnosed patients with type 2 diabetes before trying other drugs. And yet despite being one of the most prescribed medications worldwide, metformin is not mundane. In addition to its ability to lower blood glucose—safely and inexpensively—metformin may have some other tricks up its sleeve. It continues to intrigue researchers, doctors, and patients, even after more than 15 years on the U. Recent studies suggest that it may be an antidote to everything from obesity to cancer. It's not yet clear whether this humble pill will live up to the hype, but researchers are optimistic. Type 2 diabetes is marked, in part, by insulin resistance, the body's inability to lower blood glucose levels in response to the hormone insulin. Metformin helps restore the body's ability to respond to insulin, particularly in the liver.
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