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. 2016 Sep-Oct;20(5):725-729.
doi: 10.4103/2230-8210.183826.

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

Sanjay Kalra  1 , Arpit Jain  2 , Jignesh Ved  3 , A G Unnikrishnan  4
Affiliations

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

Sanjay Kalra et al. Indian J Endocrinol Metab. 2016 Sep-Oct.

Abstract

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.

Keywords: Calorie restriction mimicry canagliflozin; EMPA-REG outcome; cardiovascular outcomes; dapagliflozin; diabetes; empagliflozin; ketogenesis; ketogenic diet; liraglutide.

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Figures

Figure 1
Figure 1
Sodium-glucose cotransporter 2 inhibition: Robin Hood effect (*heart, muscle, and renal cortex. Brain utilizes ketones only in prolonged starvation. Erythrocytes do not utilize ketones as they do not have mitochondria. Liver does not utilize ketones as it does not have the enzyme thiophorase)
See this image and copyright information in PMC

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