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Inicio Medicina Clínica Abordaje de la diabetes mellitus tipo 2 a través del cotransportador sodio-gluc...
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Vol. 147. Issue SE1.
Inhibidores del cotransportador sodio-glucosa tipo 2
Pages 22-25 (November 2016)
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Vol. 147. Issue SE1.
Inhibidores del cotransportador sodio-glucosa tipo 2
Pages 22-25 (November 2016)
Abordaje de la diabetes mellitus tipo 2 a través del cotransportador sodio-glucosa tipo 2: ¿tiene sentido?
Approaching to DM2 through sodium-glucose cotransporter-2: does it make sense?
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Julián Seguraa
a Unidad de Hipertensión Arterial, Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, España
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El riñón está implicado en la homeostasis de la glucosa a través de 3 mecanismos principales: la gluconeogénesis renal, el consumo de glucosa para satisfacer las necesidades energéticas renales y la reabsorción de glucosa en el túbulo proximal. La reabsorción de glucosa es una de las funciones fisiológicas renales de más relevancia, gracias a la cual se recupera la totalidad de la glucosa filtrada, la orina queda libre de glucosa y se evita la pérdida de calorías. Aproximadamente el 90% de la glucosa es reabsorbido en el segmento S1 del túbulo proximal, donde se localizan los transportadores SGLT2 y GLUT2, mientras que el 10% restante es reabsorbido en el segmento S3, donde predominan SGLT1 y GLUT1. En pacientes con hiperglucemia, el riñón continúa reabsorbiendo glucosa, por lo que contribuye a perpetuar la hiperglucemia. La mayor parte de la reabsorción renal de glucosa está mediada por transportadores SGLT2. Varios estudios experimentales y clínicos sugieren que el bloqueo farmacológico de estos transportadores podría aportar beneficios en el manejo de la hiperglucemia en pacientes con diabetes tipo 2.

Palabras clave:
Diabetes tipo 2
Homeostasis de la glucosa
Reabsorción renal de glucosa

The kidney is involved in glucose homeostasis through three main mechanisms: renal gluconeogenesis, renal glucose consumption and glucose reabsorption in the proximal tubule. Glucose reabsorption is one of the most relevant physiological functions of the kidney, through which filtered glucose is fully recovered, urine is free of glucose, and calorie loss is prevented. Approximately 90% of the glucose is reabsorbed in the S1 segment of the proximal tubule, where GLUT2 and SGLT2 transporters are located, while the remaining 10% is reabsorbed in the S3 segment by SGLT1 and GLUT1 transporters. In patients with hyperglycaemia, the kidney continues reabsorbing glucose, and hyperglycaemia is maintained. Most renal glucose reabsorption is mediated by the SGLT2 transporter. Several experimental and clinical studies suggest that pharmacological blockade of this transporter might be beneficial in the management of hyperglycemia in patients with type 2 diabetes.

Keywords:
Type 2 diabetes
Glucose homeostasis
Renal glucose reabsorption

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