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Diabetes and Kidney Stones? This Drug Could Help

Diabetes, unfortunately, may cause kidney stones. High blood sugar levels — the signature feature of each type 1 and kind 2 diabetes — result in a significant increase in the chance of kidney stone formation. Kidney stones are well-known to be one of the crucial painful common maladies, and for those who’ve ever had one, you’ve probably thought of tips on how to prevent one other from forming.

A recent study has some excellent news for individuals who experience each diabetes and kidney stones. The evidence now shows that the category of medicine often called SGLT2 inhibitors may significantly reduce the chance of kidney stones.

Kidney Stones & Diabetes

There are multiple forms of kidney stones. Diabetes is closely linked with one specific variety, the uric acid stone.

Uric acid is a waste product that naturally circulates through the bloodstream, in keeping with the Cleveland Clinic. It’s the job of the kidneys to filter out waste like uric acid and take away it from the body through the urine. But when your body has an excessive amount of uric acid, the kidneys could also be unable to maintain up — the uric acid can collect and form crystals. If these uric acid crystals cannot pass out of your body, they might get stuck within the urinary system, causing excruciating pain and other symptoms. Diabetes and related metabolic conditions, akin to obesity and metabolic syndrome, appear to lift the acidity of the bloodstream, making uric acid stones more more likely to form.

Uric acid “urolithiasis” could also be a consequence of insulin resistance, a signature feature of type 2 diabetes. It’s less clear to what extent type 1 diabetes triggers kidney stone formation, though at the very least one study has suggested that type 1 also increases the likelihood of kidney stone formation.

Recent Evidence

In late January 2024, the medical journal JAMA Internal Medicine published a brand new study showing that SGLT2 inhibitors could reduce the chance of kidney stone formation in individuals with type 2 diabetes. The work was a collaboration between Massachusetts area experts in diabetes and nephrology, led by Julie Paik, MD, ScD, MPH.

The study examined the insurance records of over a million American adults with type 2 diabetes. They found that those that had begun using an SGLT2 inhibitor were about 30 percent less more likely to experience a kidney stone than those that used alternative glucose-lowering medications. The positive effect took hold in a short time — most patients only participated within the study for about six months.

It’s also value noting that SLGT2 inhibitors outperformed the blockbuster GLP-1 receptor agonist class, which incorporates the world’s most hyped drug, semaglutide (Ozempic). Although early evidence suggests that semaglutide may protect kidney health, the JAMA study shows that it shouldn’t be nearly as effective at stopping kidney stones. GLP-1 users were about 40 percent more more likely to receive treatment for a kidney stone.

Dr. Paik told Diabetes Day by day that the outcomes were clinically significant: “The danger of kidney stones in a patient may be one additional consideration for a clinician to have in mind when selecting amongst different glucose-lowering agents for patients with type 2 diabetes.”

SGLT2 Inhibitors

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are pills that help lower blood glucose levels by stopping the kidneys from reabsorbing the sugar in your bloodstream. Extra sugar leaves the body through the urine. They’re approved to be used in type 2 diabetes, and are also steadily prescribed off-label for individuals with type 1 diabetes.

There are 4 SGLT2 inhibitors available today in america:

SGLT2 inhibitors result in improved blood sugar levels and modest weight reduction, but diabetes experts are really enthusiastic about their ability to guard against cardiovascular and kidney disease. A review of major end result trials found that drugs within the SGLT2 class have powerful protective effects on kidney health, significantly slowing the decline of glomerular filtration rate (GFR) and the event of macroalbuminuria, two of the signature indications of kidney decline. They do that by improving blood flow reducing scarring and inflammation throughout the kidneys.

Kidney stones are greater than only a short-term misery. Paik said that “along with being quite painful, they may cause kidney damage and increase the chance of other sequelae, like urinary tract infections, heart problems, and fractures.”

Type 1 Diabetes?

Paik declined to invest on whether SGLT2 inhibitors might need the identical effect on individuals with type 1 diabetes. Though these drugs will not be officially approved to be used in type 1, they’re commonly prescribed off-label to assist with glucose control and weight reduction. There’s encouraging evidence that SGLT2 drugs also protect the kidneys of patients with type 1 diabetes, though additionally they carry a major risk of triggering diabetic ketoacidosis (DKA).


Uric Acid Stones. Cleveland Clinic. August 19, 2021.

Nerli R et al. Type 2 Diabetes Mellitus and Renal Stones. Advanced Biomedical Research. August 31, 2015.

Kacem B. Study of Urinary Crystals for Type 1 Diabetics. UroToday. 2008.

Paik J et al. Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes. JAMA Internal Medicine. January 29, 2024.

Groop P et al. Effect of Dapagliflozin as an Adjunct to Insulin Over 52 Weeks in Individuals With Type 1 Diabetes: Post-hoc Renal Evaluation of the Depict Randomised Controlled Trials. The Lancet Diabetes & Endocrinology. October 2020.

Danne T et al. International Consensus on Risk Management of Diabetic Ketoacidosis in Patients With Type 1 Diabetes Treated With Sodium–Glucose Cotransporter (SGLT) Inhibitors. Diabetes Care. June 1, 2019.

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