Introduction: More than 424 million adults have diabetes mellitus (DM). This number is expected to increase to 626 million by 2045. The majority (90-95%) of people with DM has type 2-diabetes (T2DM). The continued prevalence of DM and associated complications has prompted investigators to find new therapies. One of the most recent additions to the antidiabetic armamentarium are inhibitors of sodium-glucose co-transporters 1 and 2 (SGLT1, SGLT2). Areas covered: The authors review the status of SGLT2 inhibitors for the treatment of T2DM and place an emphasis on those agents in early phase clinical trials. Data and information were retrieved from American Diabetes Association, Diabetes UK, ClinicalTrials.gov, PubMed, and Scopus websites. The keywords used in the search were T2DM, SGLT1, SGLT2 and clinical trials. Expert opinion: The benefits of SGLT inhibitors include reductions in serum glycated haemoglobin (HbA1c), body weight, blood pressure and cardiovascular and renal events. However, SGLT inhibitors increase the risk of genitourinary tract infections, diabetic ketoacidosis and bone fractures. The development of SGLT inhibitors with fewer side effects and as combination therapies are the key to maximizing the therapeutic effects of this important class of anti-diabetic drug.

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SummaryA cross-over trial of debrisoquine and guanethidine in 32 patients showed that both drugs were equally effective in lowering both systolic and diastolic blood pressure. The degree to which they were tolerated by the patients, however, differed greatly. After three months on each drug 18 patients preferred debrisoquine, nine preferred guanethidine, and five showed no particular preference. At current prices the cost of daily treatment to the patient was cheaper with debrisoquine than with guanethidine. IntroductionPublished work shows that both guanethidine and debrisoquine are potent hypotensive agents in the management of moderate to severe cases of hypertension. Though both drugs act on the postganglionic sympathetic nerves, interfering with the release of noradrenaline at their nerve endings, their side effects though similar are not equally severe. Heffernan and Carty (1970) in their initial studies with debrisoquine were impressed with the low incidence of side effects. Though bethanidine, guanethidine, and methyldopa (Prichard et al., 1968) and debrisoquine and methyldopa (Heffernan et al., 1971) have been compared there has been no formal comparative clinical trial between debrisoquine and guanethidine. We therefore made a within-patient comparison of the effectiveness and tolerability of debrisoquine and guanethidine using the principles (with slight modifications) established by Prichard et al. (1968).