Diabetic Kidney Disease: Pathophysiology and Therapeutic Targets

Figure 4

A schematic summary of the various therapeutic agents that have been identified in the metabolic and alternative pathways is shown below. As noted in Figure 2(b), a hyperglycemic milieu shunts glucose metabolism away from the classic glycolysis pathway as is typically seen in patients with type 1 and type 2 diabetes. Sodium-glucose cotransport (SLGT2) inhibitors and Sirt1 activators play a role in alternative pathway and are noted in the upper left. SLGT2 inhibitors combat hyperglycemia by inducing glucosuria, whereas Sirt1 activators are thought to upregulate the highly conserved mechanism, autophagy.