Therapeutic lifestyle change diet enriched in legumes reduces oxidative stress in overweight type 2 diabetic patients: a crossover randomised clinical trial

Introduction: Evidence has long existed regarding the relationship between oxidative stress and diabetes. The present study was conducted to assess the effect of atorvastatin on selected oxidative stress parameters in the form of reduced glutathione (GSH), lipid peroxidation byproduct malondialdehyde (MDA) levels, glutathione –S- transferase (GST) activity and catalase (CAT) activity) and its effect on lipid profile (total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and very low density lipoprotein (VLDL) in dyslipidaemic type 2 diabetic patients . Materials and Methods: Fifty nine dyslipidaemic type 2 diabetic patients were included in this study. Full history was taken and general examination of patients was performed. Patients studied were taking glibenclamide (an oral hypoglycaemic drug) during the study as a treatment for their disease. These patients were followed up for 60 days and divided randomly into 2 groups. Group I (n = 31): no drug was given and served as dyslipidaemic diabetic control. Group II (n = 28): received atorvastatin tablets 20 mg once daily at night. Of the 59 Fifty patients, 46 completed the study while 13 patients withdrew. This is due to non compliance of the patients. Blood samples were drawn from the patients at the beginning and after 60 days of follow up between 8:30 & 10:30 am after at least 12-14 hours fast. Fasting blood glucose, lipid profile, selected oxidative stress parameters (GSH, MDA levels, GST and CAT activities) were measured. Renal and hepatic functions were also assessed. Results: This study revealed that: atorvastatin treatment increased serum GSH; reduced MDA levels significantly while did not significantly affect CAT and GST activity. In atorvastatin treatment, TC, TG, LDL and VLDL decreased significantly while HDL increased significantly. Conclusion: There was insignificant correlations between atorvastatin induced changes in the oxidation markers and the observed changes of the lipid profile.

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Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) as a Primary Preventative Agent in the Healthy Individual: A Need of a Future Randomised Clinical Trial?

Frontiers in Medicine ◽

10.3389/fmed.2021.712671 ◽

2021 ◽

Vol 8 ◽

Author(s):

Dan Xu ◽

Owain Chandler ◽

Cleo Wee ◽

Chau Ho ◽

Jacquita S. Affandi ◽

...

Keyword(s):

Heart Failure ◽

Type 2 Diabetes ◽

Clinical Trial ◽

Diabetic Patients ◽

Atherosclerotic Cardiovascular Disease ◽

Healthy Individuals ◽

Type 2 Diabetic Patients ◽

Sodium Glucose Cotransporter ◽

Type 2 Diabetic

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a relatively novel class of drug for treating type 2 diabetes mellitus (T2DM) that inhibits glucose reabsorption in the renal proximal tubule to promote glycosuria and reduce blood glucose levels. SGLT2i has been clinically indicated for treating T2DM, with numerous recent publications focussing on both primary and secondary prevention of cardiovascular and renal events in Type 2 diabetic patients. The most recent clinical trials showed that SGLT2i have moderately significant beneficial effects on atherosclerotic major adverse cardiovascular events (MACE) in patients with histories of atherosclerotic cardiovascular disease. In this review and analysis, SGLT2i have however demonstrated clinically significant benefits in reducing hospitalisation for heart failure and worsening of chronic kidney disease (CKD) irrespective of pre-existing atherosclerotic cardiovascular disease or previous heart failure history. A meta-analysis suggests that all SGLT2 inhibitors demonstrated the therapeutic benefit on all-cause and cardiovascular mortality, as shown in EMPAREG OUTCOME study with a significant decrease in myocardial infarction, without increased stroke risk. All the above clinical trial recruited type 2 diabetic patients. This article aims to postulate and review the possible primary prevention role of SGLT2i in healthy individuals by reviewing the current literature and provide a prospective overview. The emphasis will include primary prevention of Type 2 Diabetes, Heart Failure, CKD, Hypertension, Obesity and Dyslipidaemia in healthy individuals, whom are defined as healthy, low or intermediate risks patients.

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