1. SGLT2 INHIBITION: A NOVEL TREATMENT STRATEGY FOR TYPE 2 DIABETES MELLITUS

2. SGLT2 INHIBITOR: WHERE DO THEY FIT IN THE TREATMENT ALGORITHM ● Monotherapy ● Add-on to: MET, SU, PIO ● Add-on to oral combo therapy ● Double/Triple combo therapy ● Add-on to insulin in T2DM ● Add-on to insulin in T1DM ● IGT/IFG ● A1c > 10.0%

3. SGLT 2 INHIBITION: MEETING UNMET NEEDS IN DIABETES CARE Corrects a Novel Pathophysiologic Defect Reduces HbA 1c Promotes Weight Loss Complements Action of Other Antidiabetic Agents Reduces Blood Pressure No Hypoglycemia Improves Glycemic Control and CVRFs Reversal of Glucotoxicity

4. GLP1 TZDs GLP1 HYPERGLYCEMI A Decreased Incretin Effect Decreased Insulin Secretion Increased HGP Islet–  cell Increased Glucagon Secretion OMINOUS OCTET Increased Lipolysis IncreasedGlucoseReabsorption Neurotransmitter Dysfunction TZDsGLP1 TZDsGLP1 TZDsMETGLP1 Decreased Glucose Uptake

7. EXENATIDE AND NO HYPO USED WITH NO SU EXENATIDE Always try GLP-1 RA before Insulin

8. PATHOPHYSIOLOGIC-BASED (DEFRONZO) ALGORITHM Lifestyle + TRIPLE COMBINATION: PIO + Metformin + GLP-1 Analogue HbA 1c < 6.0%

9. Insulin use ben/risk