Minnie Hiker has now been a diabetic for 3 years. One morning while listening to
ID: 82437 • Letter: M
Question
Minnie Hiker has now been a diabetic for 3 years. One morning while listening to the news as she was getting ready for the day, she heard an advertisement for a relatively new drug called InvoKana. The drug claimed to stop glucose reabsorption and decrease A 1C numbers. Minnie was thrilled at this development because diet and exercise alone had not been sufficient to control her numbers and the doctor was talking about starting her on a different medication. There were side effects to the drug which included: dehydration, hyperkalemia, ketoacidosis, and kidney problems. Additionally, the advertisement warned not to take Invokana with a diuretic. Minnie comes to you as her health care provider to ask you why these side effects occur with this drug. She is taking Furosimide for high blood pressure. See if you can answer the following questions. Minnie's Questions: How does Invokana stop glucose reabsorption and decrease A1C numbers? How does this alter normal physiology for glucose processing?Explanation / Answer
1)There are presence of Sodium-glucose co-transporter 2(SGLT2) protein in humans that take part in reabsorption of glucose in the kidney.SGLT2 is located in the proximal tubule in the kidneys and accounts for 90% of glucose reabsorption by the kidneys. Invokana might act as a SGLT2 inhibitor thereby blocking the reabsorption of glucose in the kidney and increasing its excretion that ultimately lowers glucose levels in blood and decreases AIC numbers.The normal physiology for glucose processing is altered in a way that Invokana might also trigger insulin activity and more muscle glucose uptake ,decreased gluconeogenesis and enhancing the insulin release from pancreas' beta cells.