Hyperglycemia is a complex disease state that has been described as an interplay among the ominous octet 18 in which the pancreas, liver, small intestine, skeletal muscle, adipose tissue, brain and kidney all contribute to glucose metabolism. Pharmacotherapy development has effectively sought to target each of these mechanisms via various pathways. The renal reabsorption of glucose has only recently become a focus for therapeutic intervention with the introduction of sodium glucose co-transporter 2 (SGLT2) inhibitors in 2013.