Effects of antidiabetic drugs that cause glucose excretion directly from the body on mortality

Diabetes is widespread worldwide, and there is concern that the mortality rate due to diabetes will increase. Until now, various antidiabetic drugs have been used to improve the pathological condition in diabetes patients. It has been reported that some antidiabetic drugs not only improve blood glucose levels but may prolong life. Antidiabetic drugs include acarbose, metformin, and sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are considered as types of drugs that can induce direct glucose excretion from the body. The mechanism underlying the effect of these drugs is expected to involve a calorie restriction-mimicking effect by direct glucose excretion, and not just an effect whereby the disease state is improved. From the latest findings, it has become clear that these antidiabetic drugs have many health benefits not limited to the treatment of diabetes, i.e., these drugs may extend the life of not only diabetes patients but also those without diabetes. In this paper, we describe the latest findings of research on acarbose, metformin, and SGLT2 inhibitors and discuss the effects of these drugs on reducing mortality and prolonging lifespan.