New Combination of Diabetes Drugs Have Synergistic Effect

Metformin and SGLT2 inhibitors together reduce the blood sugar levels of diabetics more effectively than either drug alone…. 

A group of scientists headed by Dr. Susanne Neschen and Prof. Dr. Martin Hrabě de Angelis from the Helmholtz Zentrum München, partner in the German Center for Diabetes Research, and drug manufacturer Sanofi Aventis, have discovered how metformin and SGLT2 inhibitors can reinforce each other when used together.

SGLT2 inhibitors promote the elimination of sugar in the urine and consequently reduce the blood sugar. However, paradoxically the body reacts to this with increased sugar production in the liver and this is where metformin comes in: it slows down the body’s own sugar production. The interaction of the two substances causes a drop in blood sugar levels that is effective and prolonged, and the reduction is greater than with either substance administered on its own.

"The combination of drugs effectively reduces the blood sugar, and particularly also the blood sugar peaks after meals. In diabetic mice, the double therapy produced an improvement in the long-term blood sugar level HbA1c within only two weeks," reports first author Neschen. "The duo consequently constitutes an effective treatment strategy for type 2 diabetes while also producing minimal side effects," adds Hrabě de Angelis.

S. Neschen, M. Scheerer, A. Seelig, P. Huypens, J. Schultheiss, M. Wu, W. Wurst, B. Rathkolb, K. Suhre, E. Wolf, J. Beckers, M. Hrabe de Angelis. Metformin supports the antidiabetic effect of a sodium glucose cotransporter 2 (SGLT2) inhibitor by suppressing endogenous glucose production in diabetic mice. Diabetes, 2014; DOI:10.2337/db14-0393