The Chemistry of Gliflozins: Recent Advancements in SGLT-2 Inhibitors

Approximately 422 million individuals worldwide have been diagnosed with Diabetes Mellitus (DM), a severe metabolic disorder, within the last 30 years. The chemical pharmacology of bexagliflozin, the most recent SGLT-2i, has been investigated as a possible treatment for diabetes associated with type 2 (T2DM). Gliflozin Dapagliflozin (DAPA), canagliflozin, and bexgliflozin act by blocking the SGLT-2 protein present in both kidneys and induce the excretion of glucose in the form of urine by decreasing its reabsorption. This potentially effective treatment approach for T2DM has additional benefits, such as weight loss and cardiovascular protection. Similar to canagliflozin or dapagliflozin, explicitly, bexagliflozin is very specific and powerful for SGLT-2 inhibition. In 2023, the FDA granted approval for this medication. The levels of glucose in the blood are significantly lowered as a result of blocking the kidney’s proximal tubule from reabsorbing glucose. This study draws attention to the structural advantages of bexagliflozin. Notably, the aryl C-glycoside bond with D-glucopyranose makes this drug exhibit increased metabolic stability and distinguish itself from other gliflozins. It elaborates on advantageous A.D.M.E properties, further efficiency in lowering HbA1c levels, contributing towards weight loss, and improvement of cardiovascular and renal outcomes, mainly among patients suffering from type 2 diabetes and comorbid CKD or cardiovascular risks. It also reviews key clinical trials by focusing on its safety with manageable side effects such as urinary tract infections. Overall, a comprehensive analysis has underlined the potential of bexagliflozin as a preferred treatment in diabetes management.