Established and Emerging use of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors in Pediatric Population with Type 2 Diabetes: a Case Report and Literature Review

Valeria Castorani^*Eleonora ChiarleSilvia SavastioErica PozziCristina PartenopeCiro PignatielloSotirios DimarakisMonica DemichelisFederico MedinaIvana Rabbone

• Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, V. Solaroli 17, 28100, Novara, Italy

The incidence and prevalence of type 2 diabetes (T2D) are increasing worldwide, affecting both adults and a growing number of children and adolescents. Notably, youth-onset T2D differs in its pathogenesis from later-onset T2D and progresses more rapidly. It is associated with a higher incidence of complications, and these occur earlier. Over the past few decades, numerous therapeutic agents from various drug classes have been approved for use in adults with T2D. In contrast, there is a scarcity of approved treatments for T2D in children. Sodium-glucose cotransporter 2 (SGLT2) inhibitors represent one of the newest classes of oral hypoglycemic agents, which lower blood glucose concentrations by increasing urinary glucose excretion. They have significantly influenced the management of T2D in adults. Promising results have also been reported in the pediatric population. In particular, empagliflozin, a potent and highly selective SGLT2 inhibitor, is an effective and generally well-tolerated anti-hyperglycemic agent widely approved for the treatment of adults with T2D. It has been recently approved for the management of T2D in children aged 10 years and older, in combination with diet and exercise. Here, we report a case of empagliflozin use in a 14year-old girl with poorly controlled T2D. Furthermore, we review existing data on the use of SGLT2 inhibitors in the pediatric population.