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Mark Molitch Part 4, SGLT2 Inhibitors and Diabetes

In part 4 of this Exclusive Interview, Dr. Mark Molitch shares his thoughts on the latest diabetes drug class, SGLT2, in a conversation with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California.

Dr. Mark Molitch is the Martha Leland Sherwin Professor of Medicine at Northwestern in the
Division of Endocrinology, Metabolism and Molecular Medicine. He has been active in clinical research in diabetes, focusing on diabetic nephropathy, and other areas of endocrinology.

Transcript of this video segment:

Steve Freed: Being an endocrinologist, you have seen all these new drugs coming out. It’s like you go to sleep one night and you wake up and it’s a whole new class of drugs. And it took us so long to get to this point. There’s so many new drugs in the pipeline. What are your thoughts about the most recent class, which is the SGLT2 drugs, that we’ve found can actually prevent you from dying by 38%? And most people with diabetes, as you’re well aware, they don’t die from diabetes, they die from cardiovascular disease, heart attacks and strokes. What are your feelings about it? A lot of physician would say, “Well, let’s wait 5 more year and let’s really see what the effects are.” You remember Troglitazone, we had that issue. So, what are your personal feelings about it?

Mark Molitch: This class has now been out for three or four years and the five-year data actually are there from the EMPA-REG study, showing empagliflozin to have cardiovascular benefits and we’ll find out tomorrow whether canagliflozin also has this benefit. I don’t see any reason to keep waiting before using these drugs. They’re really fairly effective drugs with very minimum in the way of side effects and we’ll have to see how much benefit that we get. It really only two drugs that show to have cardiovascular benefits and that liraglutide and now empagliflozin. And we’ll see tomorrow about canagliflozin. So, they put them higher up on the list when you start to choose those as treatments.

Steve Freed: So where do you put it on the list? You look at metformin like it’s almost the gold standard to start somebody and then we start to add drugs. Where do you see adding SGLT2?

Mark Molitch: I think maybe as a second line drug, especially with empagliflozin, again maybe canagliflozin. The long-term cardiovascular study for dapagliflozin is ongoing whether this is class effect or single drug effect we don’t know yet.

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