Sodium-glucose cotransporter 2 inhibition and health benefits: The Robin Hood effect

• Main Authors: Sanjay Kalra, Arpit Jain, Jignesh Ved, A G Unnikrishnan
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Indian Journal of Endocrinology and Metabolism
• Subjects: Calorie restriction mimicry canagliflozin; cardiovascular outcomes; dapagliflozin; diabetes; EMPA-REG outcome; empagliflozin; ketogenesis; ketogenic diet; liraglutide
• Online Access: http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=5;spage=725;epage=729;aulast=Kalra

This review discusses two distinct, yet related, mechanisms of sodium-glucose cotransporter 2 (SGLT2) inhibition: Calorie restriction mimicry (CRM) and pro-ketogenic effect, which may explain their cardiovascular benefits. We term these adaptive CRM and pro-ketogenic effects of SGLT2 inhibition, the Robin Hood hypothesis. In English history, Robin Hood was a "good person," who stole from the rich and helped the poor. He supported redistribution of resources as he deemed fit for the common good. In a similar fashion, SGLT2 inhibition provides respite to the overloaded glucose metabolism while utilizing lipid stores for energy production.