Proteinuria, renal impairment, metabolic control, and blood pressure in type 2 diabetes mellitus. A 14-year follow-up report on 195 patients

1992 ◽  
Vol 152 (6) ◽  
pp. 1225-1229 ◽  
Author(s):  
M. Ravid
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Impairment ◽  
Metabolic Control

Abstract 11267: LX4211, a Dual Inhibitor of Sodium-Glucose Cotransporters 1 and 2, Reduces Systolic Blood Pressure in Patients With Type 2 Diabetes Mellitus and Moderate to Severe Renal Impairment

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Pablo Lapuerta ◽  
Paul Strumph ◽  
Philip Banks ◽  
Ikenna Ogbaa ◽  
Brian Zambrowicz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Impairment ◽  
Systolic Blood Pressure ◽  
Severe Renal Impairment ◽  
Postprandial Glucose ◽  
Dual Inhibitor

Introduction: Selective sodium-glucose cotransporter 2 (SGLT2) inhibitors target only the kidney, and they have reduced efficacy when patients with type 2 diabetes mellitus (T2DM) have renal impairment (RI). LX4211 blocks sodium and glucose absorption in the gastrointestinal tract by inhibition of SGLT1, and it enhances urinary sodium and glucose excretion in the urine through inhibition of SGLT2. The dual SGLT1/2 action of LX4211 was anticipated to reduce systolic blood pressure (SBP) in addition to improving glucose control in the setting of RI. Methods: This analysis explored the effect of LX4211 on SBP in a clinical trial of patients with T2DM and moderate to severe RI. Patients (N=31) were randomly assigned to be treated with LX4211 (400 mg, N=16) or placebo (N=15) qd for 7 consecutive days. Postprandial glucose levels after a standard high glucose meal served as the primary measure of pharmacodynamic activity. Baseline and Day 8 trough SBP measures were each an average of 3 seated assessments. Results: Mean baseline characteristics included age 66.4 years, estimated glomerular filtration rate (eGFR) 43.4 mL/min/1.73 m 2 , and SBP 130.9 mmHg. Postprandial glucose area under the curve (sampled from pre-dose to 4 hours post meal) was reduced from Baseline to Day 7 by 169.3 mg*hr/dL on LX4211 compared to placebo (p=0.003). Day 8 SBP reductions were 11.4 mmHg on LX4211 and 0.0 mmHg on placebo (p=0.045 for difference between groups). Patients with greater RI (eGFR <45 mL/min/1.73 m2) treated with LX4211 (N=6) had a 10.5 mmHg SBP reduction compared to 0.3 mmHg on placebo (N=9). The difference between seated and standing SBP did not change with LX4211 (0.0 mmHg change, Day 8 vs. Baseline). There were no reports of hypotension, hypovolemia, no serious adverse events, and no patient discontinued due to an adverse event. Mild hypoglycemia was reported in 1 LX4211 patient compared to 2 placebo patients. Conclusions: LX4211 may reduce SBP and enhance glycemic control in T2DM patients with moderate to severe RI.

scholarly journals Predictors of Glycemic Control Among Patients With Type 2 Diabetes in North West Ethiopia: A Longitudinal Study

2021 ◽  
Author(s):  
Nigusie Gashaye Shita ◽  
Ashagrie Sharew Iyasu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Systolic Blood Pressure ◽  
Good Glycemic Control ◽  
Type 2 Dm

Abstract Background Type 2 diabetes mellitus patients with hyperglycemia for a long period of time are significant causes of mortality and morbidity worldwide. Studying the predictors of glycemic control help to minimize deaths and the development of acute and chronic diabetes complication. Hence, the aim of this study is to asses’ predictors of glycemic control among patients with Type 2 diabetes in Ethiopia. Methods A retrospective cohort study was conducted among Type 2 Diabetes mellitus (T2DM) patients enrolled between December 2011 and December 2012 at Debre Markos and Felege Hiwot Referral Hospital. A total of 191 T2DM patients was included in the study who meets the eligibility criteria. Generalized linear mixed model was employed. Results The prevalence of good glycemic control among type 2 diabetes patients was 58.4% where as 23.25% of variation was explained in the fitted model due to adding the random effects. The significance predictors of glycemic control among patients with Type 2 diabetes at 95% confidence level were reside in rural(0.454, 0.614)), patients age 38–50, 51–59 and 60–66 years(1.267,1.776), (1.057,1.476) and (1.004, 1.403), respectively, Proteinuria positive(1.211,1.546), diastolic blood pressure ≥ 90 (1.101, 1.522), systolic blood pressure ≥ 140 (1.352, 1.895), creatinine (0.415, 0.660), duration per visit (0.913, 0.987), duration since diagnosis (0.985, 0.998), weight 78–88(0.603, 0.881). Conclusion Level of glycemic control among type 2 diabetes patients was poor. Resident, age, weight, duration of T2DM since diagnosis, duration of type 2 DM per visit, follow up time, protein urea, diastolic blood pressure, systolic blood pressure and creatinine were significant predictors of glycemic control among type 2 DM patients. During diabetic patients follow up, clinicians should give appropriate attention to these significant variables for good glycemic control since it is the main goal of diabetes management.

scholarly journals Renal evaluation in patients with type 2 diabetes mellitus and its association with diastolic blood pressure

2016 ◽  
Vol 25 (1) ◽  
pp. 25-32
Author(s):  
Fokine D. Anna ◽  
Mendieta Z. Hugo ◽  
Mendieta A.M. Ruth
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Blood Pressure ◽  
Pearson Correlation ◽  
Disease Epidemiology ◽  
The Difference

Background: HbA1c is correlated with the estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP). Our main objective was to evaluate the trend of biochemical and clinical variables, in relation to the eGFR in patients with type 2 diabetes mellitus (T2DM). Methods: This was a retrospective, longitudinal, and descriptive study, including patients with T2DM, who were cared for from January 2014 until December 2014, at the Clínica de Diabetes, Hospital Regional “Gral. Ignacio Zaragoza", ISSSTE, Mexico City, Mexico. eGFR was calculated using three formulas: the chronic kidney disease – epidemiology collaboration (CKD-EPI), Cockcroft-Gault, and modification of diet in renal disease (MDRD), during two periods of observation, 3 and 6 months. The results were compared by Student t tests or Wilcoxon-Mann-Whitney test depending on the variable distribution. Pearson correlation was employed to determine the relation between the eGFR determined with each formula and the analyzed variables. Results: The mean age was 56.5±11.3 years in the group of 3 months’ follow-up (n=110) and 57.1±13.8 years in the group of 6 months’ follow-up (n=47). In both groups, the formula with the lowest percentages of cases of CKD was CKD-EPI and the difference of this formula had a basal and final significant positive correlation with the DBP. Conclusion: The CKD-EPI formula showed the lowest percentages of cases of CKD in a short follow-up period, and its difference is consistently associated with the DBP, confirming the importance of controlling the later to mitigate the evolution to CKD.

scholarly journals Clinical And Biochemical Outcomes Of Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors In Type 2 Diabetes Mellitus Patients

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A467-A467
Author(s):  
Muhammad Saleem ◽  
Nanik Ram ◽  
Sajjad Ali Khan ◽  
Zafar Aleem Suchal ◽  
Muhammad Mustansir Mehdi Khan
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Standard Deviation ◽  
P Value ◽  
Oral Glucose ◽  
Glucose Lowering

Abstract Background: SGLT-2 inhibitors are a group of oral medications that work independently of insulin working as anti-diabetics by enhancing the excretion of glucose. The purpose of our study was to assess the improvement in terms of HbA1c, weight, blood pressure and BMI and the hepatics and renal effect in terms of SGPT and Creatinine in patients already on three oral glucose lowering agents when SGLT-2 inhibitor was added to their medications. Methods: This retrospective, real world, single center study included 99 patients (mean age [Standard Deviation]: 53.8 [9.63] years) with poorly control type 2 diabetes. Data was recorded at three times, before the addition of SGLT-2 inhibitor and then at 3 and 6 month follow up after the drug had been added in patient’s medications. Physical parameters namely weight, BMI and blood pressure were recorded in the clinic while HbA1c, SGPT and Creatinine were checked by laboratory. Results: Improvement was seen in all parameters at both 3 and 6 month follow up interval. The reduction in HbA1c was statistically significant (P-value &lt; 0.001) with (Mean Reduction [Standard Deviation)) 0.81[1.02] % at 3 months and 1.07[1.11] % at 6 months. Weight was also significantly reduced (P-value &lt; 0.001) with (MR [SD]) 1.83[2.32] kg at 3 and 4.02[6.04] kg at 6 months. Statistically significant reduction (P-value &lt; 0.001) in BMI was also seen with 0.69[0.95] kgm-2 at 3 months and 2.13[3.41] kgm-2 at 6 months of follow up. The systolic blood pressure showed significant reduction (P-value &lt; 0.05) of 5.9[15.76] mmHg at 3 months and 6.37[18.33] mmHg at 6 months. The creatinine and SGPT values of the patient showed minimal variation over the course of these 6 months of follow up. Conclusion: Our study showed that SGPT-2 can be reliably used in patients in which diabetes is not being controlled by other glucose lowering agents and is safe for use in patients in which hepatic and renal function needs to be preserved. Keywords: SGLT-2 inhibitors, Type 2 Diabetes Mellitus, Pakistan

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