Canagliflozin, an oral inhibitor of sodium/glucose cotransporter 2 (SGLT2) in 
the kidneys, leads to glucosuria and provides a unique mechanism to lower blood 
glucose levels in diabetes. It corrects a novel pathophysiological defect, has 
an insulin-independent action, reduces HbA1c by 0.5 to 1.1%, promotes weight 
loss, has a low incidence of hypoglycemia, complements the action of other 
antidiabetic agents, can be used at any stage of diabetes and appears to be safe 
in patients with compromised renal function. Due to side effects such as urinary 
tract and genital infections and decrease in blood pressure, proper patient 
selection for drug initiation and close monitoring will be important. Results of 
ongoing cardiovascular safety trials are important to determine the risk-benefit 
ratio. Canagliflozin is the first oral SGLT2 inhibitor approved in the U.S. 
market and it represents a promising approach for the treatment of diabetes in 
this era of increasing obesity.