Figure 1.

Hemodynamic responses to a sodium-glucose transporter 2 inhibitor (SGLT2i) in patients with early stage type 1 diabetes mellitus (T1DM): in the early stage of T1DM, increased proximal tubular reabsorption will decrease the distal delivery resulting in impaired tubular glomerular feedback (TGF) which presents with dilated glomerular afferent arteriolar and increased intraglomerular pressure. SGLT2i treatment will increase solute and fluid delivery to macula densa, which will enhance the secretion of adenosine, thereby increasing the afferent arteriolar resistance resulting in reducing the GFR and intraglomerular pressure. The net effects will be slightly decreased in GFR and will increase renal vascular resistance.