The comment that Dr. Stanton found extraordinary reads as follows: “Collectively, these findings prove that reduced SGLT-2 activity—whether genetically or experimentally induced—is efficacious and relatively safe ….” (1). This sentence referred to the animal studies described in the preceding paragraph, as becomes even more apparent in the following sentence that reads: “The development of SGLT-2 inhibition as a therapeutic target in type 2 diabetes is therefore logical and attractive” (2). Possibly, I should have made this clearer. On the other hand, nowhere else in the commentary do I extend judgment of efficacy or safety to pharmacological SGLT-2 inhibition in patients with diabetes. No SGLT-2 inhibitor is currently approved for use in humans, and several members in the class are being tested for both comparative efficacy and safety in clinical development programs that are in good part published or in the public domain, allowing all interested readers to be well informed.
Dr. Stanton is “even more disturbed” by my declaration of absence of potential conflict of interest. Here, I am afraid I can only confirm what I stated. The article was not an editorial—which typically expresses an editorial stance—but a commentary, which is expected to carry free opinion. It was proposed by the journal editors and not commissioned by the pharmaceutical industry. It was written by myself and not a medical writer, and I signed it in single name and, therefore, on full accountability for every word in it. There is no conflict of interest whatsoever pertaining to the views expressed in this commentary. Having been—and continuing to be—involved with clinical studies of efficacy (ref. 13 in the commentary) and mode of action (currently under way) of these pharmacological tools does not invalidate or negate a single sentence in the commentary; it is a sign of interest and not a conflict of interest. If anything, the final paragraphs highlight what is unknown about the physiological responses to pharmacologically induced glycosuria. In the clinical study cited as ref. 13—a fortiori sponsored by the drug company producing the compound under patent—Dr. Stanton will find duality of interest duly acknowledged.
No potential conflicts of interest relevant to this article were reported.