SGLT2 inhibitors lower blood glucose by:

• A. Increasing hepatic glucose production
• B. Blocking renal glucose reabsorption to increase urinary glucose excretion
• C. Inhibiting intestinal glucose absorption
• D. Stimulating insulin secretion

Answer: (B)

SGLT2 inhibitors lower blood glucose by blocking the transporter in the kidney’s proximal tubule that reabsorbs most of the filtered glucose. When this transporter is inhibited, glucose stays in the urine and is excreted (glucosuria), which reduces the amount of glucose circulating in the blood. This effect happens independent of insulin, so it can help even when insulin is low or ineffective.

This differs from options that would raise hepatic glucose production, inhibit glucose absorption in the gut, or stimulate insulin release—none of those describe the kidney-based, insulin-independent mechanism of SGLT2 inhibitors.