scholarly journals The Relationship between Increases in Morning Spot Urinary Glucose Excretion and Decreases in HbA1C in Patients with Type 2 Diabetes After Taking an SGLT2 Inhibitor: A Retrospective, Longitudinal Study

2017 ◽  
Vol 8 (3) ◽  
pp. 601-609 ◽  
Author(s):  
So Ra Kim ◽  
Yong-ho Lee ◽  
Eun Seok Kang ◽  
Bong-Soo Cha ◽  
Byung-Wan Lee
Keyword(s):  
Type 2 Diabetes ◽  
Longitudinal Study ◽  
Sglt2 Inhibitor ◽  
Urinary Glucose Excretion ◽  
Urinary Glucose ◽  
The Relationship ◽  
Glucose Excretion

scholarly journals Morning Spot Urine Glucose-to-Creatinine Ratios Predict Overnight Urinary Glucose Excretion in Patients With Type 2 Diabetes

2017 ◽  
Vol 37 (1) ◽  
pp. 9-17 ◽  
Author(s):  
So Ra Kim ◽  
Yong-ho Lee ◽  
Sang-Guk Lee ◽  
Sun Hee Lee ◽  
Eun Seok Kang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Urinary Glucose Excretion ◽  
Urine Glucose ◽  
Spot Urine ◽  
Urinary Glucose ◽  
Glucose Excretion

scholarly journals Effects of the SGLT2 Inhibitor Dapagliflozin on Energy Metabolism in Patients With Type 2 Diabetes: A Randomized, Double-Blind Crossover Trial

2021 ◽  
Author(s):  
Yvo J.M. Op den Kamp ◽  
Marlies de Ligt ◽  
Bas Dautzenberg ◽  
Esther Kornips ◽  
Russell Esterline ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Sensitivity ◽  
Energy Metabolism ◽  
Caloric Restriction ◽  
Sglt2 Inhibitor ◽  
Metabolic Effects ◽  
Night Time ◽  
Double Blind ◽  
Urinary Glucose

<b>Background:</b> SGTL2 inhibitors increase urinary glucose excretion and have beneficial effects on cardiovascular and renal outcomes; the underlying mechanism may involve caloric restriction-like metabolic effects due to urinary glucose loss. We investigated the effects of dapagliflozin on 24h energy metabolism and insulin sensitivity in patients with type 2 diabetes mellitus. <p><b>Methods</b>: Twenty-six type 2 diabetes patients were randomized to a 5-week double-blind, cross-over study with 6-8-week wash-out. 24h energy metabolism and respiratory exchange ratio (RER) were measured by indirect calorimetry, both by whole-room calorimetry and by ventilated hood during a two-step euglycemic hyperinsulinemic clamp. Results are presented as the differences in least squares mean (LSM) (95% CI) between treatments.</p> <p><b>Results</b>: Evaluable patients (n=24) had a mean (SD) age of 64<b>.</b>2(4<b>.</b>6) years, BMI of 28<b>.</b>1(2<b>.</b>4) kg/m2, and HbA1c of 6.9 (0.7)% (51<b>.</b>7 (6<b>.</b>8) mmol/mol). Rate of glucose disappearance was unaffected by dapagliflozin, while fasting endogenous glucose production (EGP) increased by dapagliflozin (+2<b>.</b>27 (1<b>.</b>39, 3<b>.</b>14) μmol/kg/min, p<0<b>.</b>0001). Insulin-induced suppression of EGP (-1<b>.</b>71 (-2<b>.</b>75, -0<b>.</b>63) μmol/kg/min, p=0<b>.</b>0036) and plasma free fatty acids (-21<b>.</b>93 (-39<b>.</b>31, -4<b>.</b>54) %, p=0.016) was greater with dapagliflozin. 24h energy expenditure (-0.11 (-0.24, 0.03) MJ/day) remained unaffected by dapagliflozin, but dapagliflozin reduced RER during day- and night-time resulting in an increased day to night-time difference in RER (-0.010 (-0.017, -0.002), p=0.016). Dapagliflozin treatment resulted in a negative 24h energy and fat balance (-20.51 (-27.90, -13.12) g/day). </p> <p><b>Interpretation</b>: Dapagliflozin treatment for 5 weeks resulted in major adjustments of metabolism mimicking caloric restriction; increased fat oxidation, improved hepatic and adipose insulin sensitivity and improved 24h energy metabolism.</p>

scholarly journals SGLT2 Inhibitors: The Star in the Treatment of Type 2 Diabetes?

Diseases ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 14
Author(s):  
Yoshifumi Saisho
Keyword(s):  
Type 2 Diabetes ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Real World Data ◽  
Renal Outcomes ◽  
Urinary Glucose ◽  
Induce Weight Loss

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of oral hypoglycemic agents which increase urinary glucose excretion by suppressing glucose reabsorption at the proximal tubule in the kidney. SGLT2 inhibitors lower glycated hemoglobin (HbA1c) by 0.6–0.8% (6–8 mmol/mol) without increasing the risk of hypoglycemia and induce weight loss and improve various metabolic parameters including blood pressure, lipid profile and hyperuricemia. Recent cardiovascular (CV) outcome trials have shown the improvement of CV and renal outcomes by treatment with the SGLT2 inhibitors, empagliflozin, canagliflozin, and dapagliflozin. The mechanisms by which SGLT2 inhibitors improve CV outcome appear not to be glucose-lowering or anti-atherosclerotic effects, but rather hemodynamic effects through osmotic diuresis and natriuresis. Generally, SGLT2 inhibitors are well-tolerated, but their adverse effects include genitourinary tract infection and dehydration. Euglycemic diabetic ketoacidosis is a rare but severe adverse event for which patients under SGLT2 inhibitor treatment should be carefully monitored. The possibility of an increase in risk of lower-extremity amputation and bone fracture has also been reported with canagliflozin. Clinical trials and real-world data have suggested that SGLT2 inhibitors improve CV and renal outcomes and mortality in patients with type 2 diabetes (T2DM), especially in those with prior CV events, heart failure, or chronic kidney disease. Results of recent trials including individuals without diabetes may change the positioning of this drug as ″a drug for cardiorenal protection″. This review summarizes the potential of SGLT2 inhibitors and discusses their role in the treatment of T2DM.

scholarly journals Potential mechanisms underlying cardiovascular protection by sodium glucose cotransporter 2 inhibitors (empagliflozin)

2021 ◽  
Vol 10 (3) ◽  
pp. 79-89
Author(s):  
I. S. Sabirov ◽  
I. T. Murkamilov ◽  
V. V. Fomin
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Controlled Clinical Trial ◽  
Sodium Glucose Cotransporter ◽  
Pubmed Database ◽  
Urinary Glucose

The presented literature review is devoted to the cardioprotective capabilities of a new class of antihyperglycemic drugs - sodium-glucose cotransporter 2 inhibitors (SGLT2), which improve glycemic control through an insulin-independent mechanism of action associated with an increase in urinary glucose excretion. The article presents the results of large-scale clinical trials on the use of SGLT2 inhibitors in patients with and without diabetes, and with cardiovascular diseases or multiple cardiovascular risk factors. A number of the most frequently discussed cardiac specific mechanisms mediated by the SGLT2 inhibitor affecting the Abstract           state of the cardiovascular system are presented. Moreover, the article presents the results of a placebo-controlled clinical trial entitled “Empagliflozin reduces mortality in patients with type 2 diabetes at high cardiovascular risk” (EMPA-REG oUtcOmE) to analyze the cardioprotective capabilities of SGLT2 inhibitor empagliflozin in patients with type 2 diabetes and concomitant cardiovascular diseases. The article emphasizes the importance of further research to determine the degree of contribution of the above-mentioned mechanisms to the cardioprotective potential of SGLT2 inhibitors. PubMed database was used to identify relevant studies and systematic reviews.

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