scholarly journals Switch to SGLT2 Inhibitors and Improved Endothelial Function in Diabetic Patients with Chronic Heart Failure

2021 ◽  
Author(s):  
Michele Correale ◽  
Pietro Mazzeo ◽  
Adriana Mallardi ◽  
Alessandra Leopizzi ◽  
Lucia Tricarico ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Endothelial Function ◽  
Vascular Function ◽  
Randomized Study ◽  
Experimental Models ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Oral Hypoglycemic Agents

Abstract Purpose The use of sodium-glucose-cotransporter-type-2 inhibitors (SGLT2i) was associated in previous studies with an improved vascular function in non-human experimental models. We therefore sought to evaluate possible changes in endothelial function assessed by flow-mediated dilation (FMD) in patients with chronic heart failure (CHF) and type-2 diabetes mellitus (T2DM), switching from other oral hypoglycemic agents to SGLT2i in an observational study. Methods Twenty-two consecutive outpatients with CHF and T2DM were enrolled after switching to SGLT2i therapy, and compared with 23 consecutive controls from the same registry comparable for principal clinical characteristics. In all patients, endothelial function was assessed by FMD at baseline and after 3 months of follow-up. Results Three months of therapy with SGLT2i were associated with a statistically significant improvement in endothelial function (19.0 ± 5.7% vs 8.5 ± 4.1%, p < 0.0001); baseline levels of FMD were comparable between groups (p n.s.). Therapy with SGLT2i was significantly associated to improved FMD levels even at multivariable stepwise regression analysis (p < 0.001). Conclusions Switch to SGLT2i in patients with CHF and T2DM was associated in an observational non-randomized study with an improved endothelial function.

scholarly journals COMPARATIVE STUDY OF ORAL HYPOGLYCEMIC AGENTS IN TYPE-2 DIABETES OBESE PATIENTS

2018 ◽  
Vol 11 (6) ◽  
pp. 505
Author(s):  
Venkateswarlu Konuru ◽  
Ram Mohan Reedy T
Keyword(s):  
Blood Sugar ◽  
Adverse Drug Reactions ◽  
Glycosylated Hemoglobin ◽  
Dipeptidyl Peptidase ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Drug Reactions ◽  
Oral Hypoglycemic Agents ◽  
Peptidase Inhibitors

  Objectives: The aim of this study was to evaluate safety and efficacy of oral hypoglycemic agents in obese Type-2 diabetic patients. The objectives are to compare fasting and postprandial blood sugar (PPBS) levels, to compare body mass index (BMI) in all the groups, and to identify glycosylated hemoglobin levels and adverse drug reactions (if present) in all the groups.Method: This is a prospective observational study conducted in care diabetic center over a period of 1 year. All the patients those are receiving only oral hypoglycemic agents continuously over a period of 3 months and BMI ≥30 were enrolled. The patients receiving insulin were excluded. Patients were followed over a period of 3 months and were reviewed on visit basis (every 30 days). All the necessary information was collected into the data collection form that includes demographic details (age, gender, etc.), past medication history, current treatment charts, and their relevant laboratory reports (fasting blood sugar levels [mg/dl], PPBS levels [mg/dl], glycosylated hemoglobin A1c [HbA1c] (%), and BMI [kg/m2]).  Results: A total of 395 patients were recruited into the study and the drugs received by the population were found to be metformin+sulfonylureas (33%), metformin+pioglitazone (26%), and metformin+dipeptidyl peptidase inhibitors (DPI) (23%). A significant reduction in HbA1c was seen in all groups of patients. Adverse drug reactions observed were hypoglycemia, pedal edema, and itching distributed to drugs metformin+DPI, respectively. A significant reduction in BMI was seen in patients receiving DPI and BMI was found to be increased in other groups of patients.Conclusion: Overall, three classes of drugs were found to have similar efficacy. Sulfonylureas were commonly associated with hypoglycemia when compared to other drugs and weight reduction observed in dipeptidyl peptidase inhibitors.

scholarly journals MnSOD protects against COX1-mediated endothelial dysfunction in chronic heart failure

2010 ◽  
Vol 298 (5) ◽  
pp. H1600-H1607 ◽  
Author(s):  
Jordan D. Miller ◽  
Veronica A. Peotta ◽  
Yi Chu ◽  
Robert M. Weiss ◽  
Kathy Zimmerman ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Vascular Function ◽  
Manganese Superoxide Dismutase ◽  
Reduced Ejection Fraction ◽  
Manganese Superoxide ◽  
Cox Inhibitor

Endothelial function is impaired by oxidative stress in chronic heart failure (HF). Mechanisms that protect against increases in oxidative stress in HF are not clear. The goal of this study was to determine whether manganese superoxide dismutase (MnSOD) plays a key role in protecting against endothelial dysfunction in HF. Endothelial function and gene expression were examined in aorta from wild-type mice (MnSOD+/+) and mice deficient in MnSOD (MnSOD+/−) 12 wk after ligation of the left coronary artery (LCA). LCA ligation produced similar size myocardial infarctions in MnSOD+/+ and MnSOD+/− mice and reduced ejection fraction to ∼20% in both groups. Maximal relaxation in response to acetylcholine was 78 ± 3% (mean ± SE) and 66 ± 8% in sham-operated MnSOD+/+ and MnSOD+/− mice, respectively. Expression of antioxidant enzymes increased in MnSOD+/+ mice with HF, and maximal relaxation to acetylcholine was slightly impaired (68 ± 4%). Greater endothelial dysfunction was observed in MnSOD+/− mice with HF (46 ± 5%, P < 0.05), which was significantly improved by polyethylene glycol-catalase but not Tempol. Incubation with the nonspecific cyclooxygenase (COX) inhibitor indomethacin or the COX1 inhibitor valeryl salicylate, but not the COX-2 inhibitor NS-398, significantly improved relaxation to acetylcholine in HF mice (maximum relaxation = 74 ± 5, 91 ± 1, and 58 ± 5%). These data suggest that MnSOD plays a key role in protecting against endothelial dysfunction in HF. A novel mechanism was identified whereby chronic increases in oxidative stress, produced by mitochondrial SOD deficiency, impair vascular function via a hydrogen peroxide-dependent, COX1-dependent, endothelium-derived contracting factor.

scholarly journals Reported Benefits of Insulin Therapy for Better Glycemic Control in Type 2 Diabetic Patients–-Is this Applicable in Saudi Patients?

2016 ◽  
Vol 9 ◽  
pp. CMED.S38077 ◽  
Author(s):  
Wafaa AlSaggaf ◽  
Mohammed Asiri ◽  
Balgees Ajlan ◽  
Alaa Bin Afif ◽  
Roaa Khalil ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Treatment Plan ◽  
Combined Therapy ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Oral Hypoglycemic Agents ◽  
The Mean

Aim To compare the effect of different treatment regimens (oral hypoglycemic agents [OHGs], insulin therapy, and combination of both) on glycemic control and other cardiometabolic risk factors in type 2 diabetes mellitus (T2DM) patients in Saudi. Subjects and Methods Patients with T2DM, but no serious diabetic complications, were randomly recruited from the diabetes clinics at two large hospitals in Jeddah, Saudi Arabia, during June 2013 to July 2014. Only those without change in treatment modality for the last 18 months were included. Blood pressure and anthropometric measurements were measured. Treatment plan was recorded from the patients' files. Fasting blood sample was obtained to measure glucose, HbA1c, and lipid profile. Results A total of 197 patients were recruited; 41.1% were men and 58.9% were women. The mean (±SD) age was 58.5 ± 10.5 years. Most patients (60.7%) were on OHGs, 11.5% on insulin therapy, and 27.7% were using a combination of insulin and OHGs. The mean HbA1c was lower in patients using OHGs only, compared with means in those using insulin, or combined therapy in patients with disease duration of #10 years ( P = 0.001) and also in those with a longer duration of the disease ( P < 0.001). A lower mean diastolic and systolic blood pressure was found among patients on insulin alone ( P < 0.01). No significant differences were found in lipid profiles among the groups. Conclusion Insulin therapy, without adequate diabetes education, fails to control hyperglycemia adequately in Saudi T2DM patients. There is a challenge to find out reasons for poor control and the ways as to how to improve glycemic control in T2DM.

scholarly journals A study on management of type 2 diabetic patients with complications

2019 ◽  
Vol 8 (8) ◽  
pp. 1870
Author(s):  
Shruti Vihang Brahmbhatt ◽  
Bhagya M. Sattigeri
Keyword(s):  
Public Health Problem ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Major Public Health Problem ◽  
Oral Hypoglycemic Agents ◽  
Type 2 Diabetic Patients ◽  
Oral Antidiabetic Agents ◽  
Oral Antidiabetic ◽  
Informed Consent Form

Background: Diabetes is a major public health problem both in developing and non-developing countries across the world. It is a chronic disease, which in long term causes several complications resulting in poly pharmacy for its management. Hence, this study was determined to analyze the drug utilization pattern for the management of type 2 diabetes with complications.Methods: A prospective, observational and non-interventional study was carried out in 100 diabetic patients with one or other complications admitted in medicine wards at Dhiraj Hospital. Patients who signed informed consent form were only included in the study. All the data were recorded from patients’ case files and analyzed.Results: Result of total 100 patients, maximum number 52 (52%) were falling in group of 61-70 kg and only 2 (2%) in 81-90 kg. Out of 100 diabetic patients, 40 (40%) were managed with insulin in addition to oral antidiabetic agents, 37 (37%) were managed with only Oral Hypoglycemic Agents (OHA) and 23 (23%) were managed with only insulin. The most commonly prescribed oral antidiabetic group of drug was Biguanides in 60 (60%) and most prescribed insulin was short acting Insulin in 40 (40%) patients.Conclusions: The diabetic patients are more prone to cardiovascular and other complications leading to a co morbid condition. The poly pharmacy is likely to occur in diabetic patients suffering with secondary complications. Therefore, intense blood sugar control with proper education can prevent the co morbid state and finally helps in reducing the economic burden.

scholarly journals Clinical Prole of Chronic Heart Failure in Hospitalized Type 2 Diabetic Patients

2018 ◽  
Vol 6 (1-2) ◽  
pp. 67-70
Author(s):  
Shahana Parveen ◽  
AMB Safdar ◽  
Faria Afsana ◽  
AKM Mohibullah ◽  
Ramendra Nath Sarker
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Regional Wall Motion ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities ◽  
The Mean ◽  
Type 2 Diabetic

Objective: To see the clinical profile of chronic heart failure in hospitalized type 2 diabetic subjects. Method: This cross-sectional study was carried out on a total of 100 type 2 diabetic patients with chronic heart failure, in the Department of Cardiology, BIRDEM, over a period of six months between July to December 2012. Results: The mean age of the study subjects was 60.9 ± 11.7 years with male to female ratio being roughly 2:1. The mean duration of diabetes mellitus was 9.15 years. Among the study subjects 72% were on insulin and 18% on oral hypoglycemic agents; 10% were on combined insulin and oral hypoglycemic agent. Dyspnea and cough were invariably present. About 88% subjects had edema, 39% raised JVP, and 13% murmur. Bilateral basal crepitation was found in 56% cases. While mean fasting blood glucose (FBG), postprandial blood glucose (PPBG) level and HbA1C were 10 mmol/l, 16.7 mmol/l and 9.9% respectively, mean serum creatinine was 2.07 mg/dl. Among study subjects, raised ESR (48%), elevated WBC count (50%) and raised BNP level (64.6%) were seen. Chest X- ray revealed cardiomagaly (70%), reticulonodular shadow in both lung fields (11%) and septal thickening (15%). ECG findings of the patients were old infarct (72%), IHD (66%), RV hypertrophy (40%) and arrhythmia (17%). Most common echocardiographic findings of the subjects were regional wall motion abnormalities (78%), Mild LV systolic dysfunction (64%) with Grade-I diastolic dysfunction being 70% and moderate to severe pulmonary arterial hypertension being 40%. Conclusion: Raised BNP level, presence of old infarct in ECG and regional wall motion abnormalities in echocardiography are the common clinical findings among patients with chronic heart failure. Ibrahim Card Med J 2016; 6 (1&2): 67-70

Gut Incretin Release as a Mediator of Metabolic Effects of Metformin in Type 2 Diabetic Patients with Chronic Heart Failure

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 465-P
Author(s):  
EVA STOLARIKOVA ◽  
JAN KOPECKY ◽  
JIRI VELEBA ◽  
KATERINA VELEBOVA ◽  
LENKA BELINOVA ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Metabolic Effects ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic
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