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Adverse effects of SGLT2 inhibitors on bone health

Sodium–glucose cotransporter 2 (SGLT2) inhibitors provide metabolic and cardiorenal benefits for patients with type 2 diabetes but are associated with a number of safety issues. Here, we discuss evidence suggesting that indirect activation of the FGF23–1,25-dihydroxyvitamin D–parathyroid hormone axis by SGLT2 inhibition might contribute to adverse effects on bone health.

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Fig. 1: Time course of pharmacodynamic responses to canagliflozin treatment.

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Acknowledgements

J.E.B. is supported by funding from the Intramural Research Program of the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). S.I.T. acknowledges funding from the NIDDK (grant number P30DK072488).

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Correspondence to Simeon I. Taylor.

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J.E.B. declares no competing interests. S.I.T. is a consultant for Ionis Pharmaceuticals, has research support provided to the University of Maryland School of Medicine by Regeneron Pharmaceuticals and has ownership of stock in Celgene, Amgen and Abbott Laboratories.

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Blau, J.E., Taylor, S.I. Adverse effects of SGLT2 inhibitors on bone health. Nat Rev Nephrol 14, 473–474 (2018). https://doi.org/10.1038/s41581-018-0028-0

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