scholarly journals Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

2019 ◽  
Author(s):  
Haruka Tamura ◽  
Yoshinobu Kondo ◽  
Kohei Ito ◽  
Masanori Hasebe ◽  
Shinobu Satoh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Endothelial Function ◽  
Body Fluid ◽  
Microvascular Complications ◽  
Fluid Volume ◽  
The Body ◽  
Controlled Study ◽  
Body Fluid Volume

Abstract Background: Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes and death from any cause. Alternatively, treatment with sulfonylurea reduces microvascular complications in diabetes but appears to increase cardiovascular hospitalization or mortality in combination with metformin. Therefore, in the present study, we assessed the effects of empagliflozin and glimepiride, a sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes. Methods: In this prospective, open-label, randomized, parallel-group comparison, 58 patients with type 2 diabetes were administered metformin and glargine before bedtime for 12 weeks, followed by the random addition of 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), which was measured prior to and following 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. Results: Analysis of the empagliflozin group (n = 30) and glimepiride group (n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P ＝ 0.79). Likewise, glycated hemoglobin (HbA1c) changes were similar between the two groups. Body weight changes significantly differed (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). However, analysis of the body composition revealed that body fluid volume significantly decreased only after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03). Conclusions: Empagliflozin did not improve endothelial function compared with glimepiride in patients with type 2 diabetes, but decreased their body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protecting endothelial function but rather from reducing the risk of heart failure.

scholarly journals Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

2019 ◽  
Author(s):  
Haruka Tamura ◽  
Yoshinobu Kondo ◽  
Kohei Ito ◽  
Masanori Hasebe ◽  
Shinobu Satoh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Endothelial Function ◽  
Body Fluid ◽  
Microvascular Complications ◽  
Fluid Volume ◽  
The Body ◽  
Controlled Study ◽  
Body Fluid Volume

Abstract Background: Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes and death from any cause. Alternatively, treatment with sulfonylurea reduces microvascular complications in diabetes but appears to increase cardiovascular hospitalization or mortality in combination with metformin. Therefore, in the present study, we assessed the effects of empagliflozin and glimepiride, a sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes. Methods: In this prospective, open-label, randomized, parallel-group comparison, 58 patients with type 2 diabetes were administered metformin and glargine before bedtime for 12 weeks, followed by the random addition of 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), which was measured prior to and following 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. Results: Analysis of the empagliflozin group (n = 30) and glimepiride group (n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P = 0.79). Likewise, glycated hemoglobin (HbA1c) changes were similar between the two groups. Body weight changes significantly differed (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). However, analysis of the body composition revealed that body fluid volume significantly decreased only after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03). Conclusions: Empagliflozin did not improve endothelial function compared with glimepiride in patients with type 2 diabetes, but decreased their body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protecting endothelial function but rather from reducing the risk of heart failure.

scholarly journals Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

2019 ◽  
Author(s):  
Haruka Tamura ◽  
Yoshinobu Kondo ◽  
Kohei Ito ◽  
Masanori Hasebe ◽  
Shinobu Satoh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Endothelial Function ◽  
Cardiovascular Events ◽  
Body Fluid ◽  
Microvascular Complications ◽  
Fluid Volume ◽  
Controlled Study ◽  
Body Fluid Volume

Abstract Background : Patients with type 2 diabetes at high risk of cardiovascular events and receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes and death from any cause. Alternatively, treatment with sulfonylurea reduces microvascular complications in diabetes but appears to increase cardiovascular hospitalization or mortality in combination with metformin. In the present study, we therefore assessed the effects of empagliflozin and glimepiride, a sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes. Methods : In this prospective, randomized, parallel-group comparison, 58 patients with type 2 diabetes were administered metformin and glargine before bedtime for 12 weeks, followed by the random addition of 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was FMD changes (ΔFMDs), which were measured prior to and following 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. Results : Analysis of the empagliflozin group ( n = 30) and glimepiride group ( n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P ＝ 0.79); likewise, HbA1c changes were similar between the groups. Body weight changes significantly differed (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). However, analysis of body composition revealed that body fluid volume significantly decreased only after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03). Conclusions : Empagliflozin did not improve endothelial function compared with glimepiride in patients with type 2 diabetes, but decreased body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protecting endothelial function but rather from reducing heart failure.

scholarly journals Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

2020 ◽  
Author(s):  
Haruka Tamura ◽  
Yoshinobu Kondo ◽  
Kohei Ito ◽  
Masanori Hasebe ◽  
Shinobu Satoh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Endothelial Function ◽  
Body Fluid ◽  
Microvascular Complications ◽  
Additional Treatment ◽  
The Body ◽  
Controlled Study ◽  
Significant Difference

Abstract Background: Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcomes and death from any cause. While treatment with sulfonylurea reduces microvascular complications in diabetes, it increases cardiovascular hospitalization or mortality when combined with metformin. In the present study, we assessed the effects of empagliflozin and glimepiride, a commonly prescribed sulfonylurea, on endothelial function using flow-mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes.Methods: In this prospective, open-label, randomized, parallel-group study, 58 patients with type 2 diabetes received metformin and glargine before bedtime for 12 weeks. This was followed by additional treatment with either 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), measured prior to and after 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition.Results: An analysis of the empagliflozin group (n = 30) and glimepiride group (n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P = 0.79). Similarly, changes in glycated hemoglobin were similar between the two groups. However, a significant difference in body weight changes was observed between the two groups (empagliflozin, −0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). In addition, an analysis of the body composition revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, −0.33 ± 0.72 L; P = 0.03).Conclusions: Empagliflozin did not improve endothelial function when compared to that with glimepiride for patients with type 2 diabetes but decreased body fluid volumes. This suggested that the coronary-protective effect of empagliflozin is not derived from protection of the endothelial function but rather from a reduction in the risk of heart failure.Trial Registration: This trial was registered on September 13, 2016; UMIN000024001.

scholarly journals Comparison of the effects of empagliflozin and glimepiride on endothelial function in patients with type 2 diabetes: A randomized controlled study

2020 ◽  
Author(s):  
Haruka Tamura ◽  
Yoshinobu Kondo ◽  
Kohei Ito ◽  
Masanori Hasebe ◽  
Shinobu Satoh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Endothelial Function ◽  
Body Fluid ◽  
Additional Treatment ◽  
Fluid Volume ◽  
Controlled Study ◽  
Flow Mediated Dilation ◽  
Body Fluid Volume

Abstract Abstract Background : Among patients with type 2 diabetes and established cardiovascular disease, those receiving empagliflozin have a lower rate of primary composite cardiovascular outcome and death from any cause. While treatment with sulfonylurea reduces microvascular complications in diabetes, it increases cardiovascular hospitalization or mortality in combination with metformin. In the present study, we assessed the effects of empagliflozin and glimepiride, a commonly prescribed sulfonylurea, on endothelial function using flow–mediated dilation (FMD) to estimate arteriosclerosis and cardiovascular events in patients with type 2 diabetes. Methods : In this prospective, open-label, randomized, parallel-group study, 58 patients with type 2 diabetes received metformin and glargine before bedtime for 12 weeks. This was followed by additional treatment with either 10 mg empagliflozin or 0.5 mg glimepiride for 12 weeks. The primary outcome was the change in the FMD measurement (DFMDs), measured prior to and after 12 weeks of additional treatment. Secondary outcomes comprised changes in metabolic markers and body composition. Results : Analysis of the empagliflozin group ( n = 30) and glimepiride group ( n = 28) showed no significant differences in DFMDs (empagliflozin, −0.19 ± 2.34%; glimepiride, −0.37 ± 2.77%; P = 0.79). Similarly, changes in glycated hemoglobin (HbA1c) were similar between the two groups. However, significant difference in body weight changes were observed between the two groups (empagliflozin, –0.59 ± 2.5 kg; glimepiride, 1.2 ± 3.0 kg; P = 0.02). In addition, an analysis of the body composition revealed that body fluid volume significantly decreased after empagliflozin treatment (baseline, 35.8 ± 6.8 L; after 12 weeks, –0.33 ± 0.72 L; P = 0.03). Conclusions : Empagliflozin did not improve endothelial function when compared to glimepiride in patients with type 2 diabetes but decreased their body fluid volume. This suggested that the coronary protective effect of empagliflozin is not derived by protection of the endothelial function but rather from reduction in the risk of heart failure. Trial Registration : This trial was registered on September 13, 2016; UMIN000024001 . Keywords: Empagliflozin, Endothelial function, Glimepiride, Diabetes, Flow–mediated dilation

scholarly journals Reduction of estimated fluid volumes following initiation of empagliflozin in patients with type 2 diabetes and cardiovascular disease: a secondary analysis of the placebo-controlled, randomized EMBLEM trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Atsushi Tanaka ◽  
Michio Shimabukuro ◽  
Hiroki Teragawa ◽  
Yosuke Okada ◽  
Toshinari Takamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Repeated Measures ◽  
Medical Information ◽  
Controlled Trial ◽  
Extracellular Volume ◽  
Cardiovascular Outcomes ◽  
Fluid Volume ◽  
The Body

Abstract Backgrounds/Aim Sodium glucose co-transporter 2 inhibitors promote osmotic/natriuretic diuresis and reduce excess fluid volume, and this improves cardiovascular outcomes, including hospitalization for heart failure. We sought to assess the effect of empagliflozin on estimated fluid volumes in patients with type 2 diabetes and cardiovascular disease (CVD). Methods The study was a post-hoc analysis of the EMBLEM trial (UMIN000024502), an investigator-initiated, multi-center, placebo-controlled, double-blinded, randomized-controlled trial designed primarily to evaluate the effect of 24 weeks of empagliflozin treatment on vascular endothelial function in patients with type 2 diabetes and established CVD. The analysis compared serial changes between empagliflozin (10 mg once daily, n = 52) and placebo (n = 53) in estimated plasma volume (ePV), calculated by the Straus formula and estimated the extracellular volume (eEV), determined by the body surface area, measured at baseline and 4, 12, and 24 weeks after initiation of treatment. Correlations were examined between the changes from baseline to week 24 in each estimated fluid volume parameter and several clinical variables of interest, including N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration. Results In an analysis using mixed-effects models for repeated measures, relative to placebo empagliflozin reduced ePV by − 2.23% (95% CI − 5.72 to 1.25) at week 4, − 8.07% (− 12.76 to − 3.37) at week 12, and − 5.60% (− 9.87 to − 1.32) at week 24; eEV by − 70.3 mL (95% CI − 136.8 to − 3.8) at week 4, − 135.9 mL (− 209.6 to − 62.3) at week 12, and − 144.4 mL (− 226.3 to − 62.4) at week 24. The effect of empagliflozin on these parameters was mostly consistent across various patient clinical characteristics. The change in log-transformed NT-proBNP was positively correlated with change in ePV (r = 0.351, p = 0.015), but not with change in eEV. Conclusions Our data demonstrated that initiation of empagliflozin treatment substantially reduced estimated fluid volume parameters in patients with type 2 diabetes and CVD, and that this effect was maintained for 24 weeks. Given the early beneficial effect of empagliflozin on cardiovascular outcomes seen in similar patient populations, our findings provide an important insight into the key mechanisms underlying the clinical benefit of the drug. Trial registration University Medical Information Network Clinical Trial Registry, number 000024502

scholarly journals Differential effects of sodium-glucose cotransporter 2 inhibitor and low-carbohydrate diet on body composition and metabolic profile in obese diabetic db/db mice

2020 ◽  
Vol 8 (1) ◽  
pp. e001303
Author(s):  
Toru Kusakabe ◽  
Shigefumi Yokota ◽  
Mika Shimizu ◽  
Takayuki Inoue ◽  
Masashi Tanaka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Metabolic Profile ◽  
The Body ◽  
Carbohydrate Diet ◽  
Glucose Levels ◽  
Low Carbohydrate Diet ◽  
Sodium Glucose Cotransporter ◽  
Low Carbohydrate

IntroductionTreatment using sodium-glucose cotransporter (SGLT) 2 inhibitor and low-carbohydrate diet (LCD) for obesity and type 2 diabetes are similar in terms of carbohydrate limitation. However, their mechanisms of action differ, and the effects on the body remain unclear. We investigated the effects of SGLT2 inhibitor and LCD on body composition and metabolic profile using the db/db mouse model for obesity and type 2 diabetes.Research design and methodsEight-week-old male db/db mice were divided into four groups: mice receiving normal diet and vehicle or canagliflozin (Cana) administration and mice receiving LCD and vehicle or Cana administration for 8 weeks. Consumed calories were adjusted to be equal among the groups.ResultsBoth Cana administration and LCD feeding resulted in significant weight gain. Cana administration significantly decreased plasma glucose levels and increased plasma insulin levels with preservation of pancreatic β cells. However, LCD feeding did not improve plasma glucose levels but deteriorated insulin sensitivity. LCD feeding significantly reduced liver weight and hepatic triglyceride content; these effects were not observed with Cana administration. Combined treatment with LCD did not lead to an additive increase in blood β-ketone levels.ConclusionsSGLT2 inhibitors and LCD exert differential effects on the body. Their combined use may achieve better metabolic improvements in obesity and type 2 diabetes.

Effects of metformin on the body composition in subjects with risk factors for type 2 diabetes

2005 ◽  
Vol 7 (2) ◽  
pp. 189-192 ◽  
Author(s):  
J. R. Rodriguez-Moctezuma ◽  
G. Robles-Lopez ◽  
J. M. Lopez-Carmona ◽  
M. J. Gutierrez-Rosas
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Body Composition ◽  
The Body

Quantitative Estimation of Dietary Intake in Patients on Hemodialysis

1988 ◽  
Vol 11 (3) ◽  
pp. 161-168 ◽  
Author(s):  
G. Kimura ◽  
S. Kojima ◽  
F. Saito ◽  
Y. Kawano ◽  
M. Imanishi ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Dietary Protein ◽  
Body Fluid ◽  
Sodium Intake ◽  
Fluid Volume ◽  
The Body ◽  
Simple Method ◽  
Potassium Intake ◽  
Dietary Record ◽  
Body Fluid Volume

A simple method to calculate the amount of dietary (protein, sodium and potassium) intake in hemodialyzed patients was developed. In 8 nutritionally stable patients, the amount of dietary intake was monitored conventionally by a dietary record method. In contrast, assuming that the amount of dietary intake was equal to the amount of accumulation in the body, the former was calculated as the change in the product of serum concentrations and total body fluid volume, which was estimated based on the sex and body build of each patient. The urea accumulation was converted to the protein intake. The interdialytic dietary protein and sodium intake calculated by this method, 120 ± 10 g and 240 ± 40 mEq, respectively, was not significantly different from that obtained by the dietary record, while the interdialytic potassium accumulation, 60 ± 7 mEq, was significantly smaller than the dietary intake, 110 + 9 mEq, obtained by the record method, though the correlation was significant. Thus, the amount of protein and sodium intake can be calculated simply without diet research or body fluid volume measurements. Although potassium intake can not be calculated exactly because of intestinal loss, this simple method gives us a rough estimate. In addition, multiple regression analysis showed that the amount of energy intake obtained by the record method may be explained by the protein and sodium intake estimated by simple calculation.

Long-term arterial pressure control: an analysis from animal experiments and computer and graphic models

1990 ◽  
Vol 259 (5) ◽  
pp. R865-R877 ◽  
Author(s):  
A. C. Guyton
Keyword(s):  
Arterial Pressure ◽  
Body Fluid ◽  
Animal Experiments ◽  
Pressure Control ◽  
Feedback Mechanism ◽  
Fluid Volume ◽  
The Body ◽  
Feedback Gain ◽  
Body Fluid Volume

Long-term arterial pressure control is very different from acute control, because many of the acute control systems are overridden by a single long-term mechanism that has little to do with short-term control. This is the renal fluid volume mechanism for pressure control. It is based on a simple functional property of the kidney: as the arterial pressure rises, the kidney output of water and electrolytes increases dramatically. When the output rises above the net intake of water and electrolytes, negative body fluid balance occurs, causing both the body fluid volume and the pressure to decrease. This decrease continues until the kidney fluid output exactly balances the net fluid intake. Conversely, if the pressure falls below the exact level for balance, intake becomes greater than output; then fluid builds up in the body and the pressure rises until intake and output again exactly balance each other. This fluid mechanism for pressure control has been known from the beginning of blood pressure research. However, its overpowering importance was not appreciated until a mathematical computer analysis in 1966 demonstrated the renal-fluid feedback mechanism to have infinite feedback gain for long-term pressure control. This is the principal topic of the present review.

scholarly journals RANTES 59029A/G Polymorphisms Associated with Diabetic Compilations in Korean Patients with Type 2 Diabetes for over 15 Years

Genes ◽  
2021 ◽  
Vol 12 (9) ◽  
pp. 1445
Author(s):  
Dong-Hwa Lee ◽  
Eu-Jeong Ku ◽  
Tae-Keun Oh ◽  
Hyun-Jeong Jeon
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
The Body ◽  
Obese Group ◽  
Retrospective Case ◽  
Korean Patients ◽  
Artery Disease ◽  
Diabetic Microvascular Complications ◽  
Control Study

Background: Polymorphisms in the RANTES gene are known to be associated with several diseases related to insulin resistance. In this study, we investigated the association between RANTES 59029A/G polymorphisms and the prevalence of diabetic complications relative to obesity in Korean patients who had type 2 diabetes (T2D) for over 15 years. Methods: A single-center, retrospective case-control study was performed. We included 271 patients with a duration of diabetes greater than 15 years. Polymerase chain reaction-restriction fragment length polymorphism was used to analyze RANTES polymorphisms, identifying genotypes as GG, AG, or AA. Obesity was defined using the body mass index with a cutoff value of 25 kg/m2. Both microvascular (retinopathy and nephropathy) and macrovascular (coronary artery disease and cerebrovascular disease) complications were evaluated. Results: The duration of T2D and hemoglobin A1c values at enrollment were 24.4 ± 5.0 years and 7.8 ± 1.6%, respectively, in the non-obese group, and 25.4 ± 6.1 years and 7.7 ± 1.7%, respectively, in the obese group. The prevalence of microvascular complications was significantly higher in the obese group compared with that in the non-obese group (83.5% vs. 72.0%, p = 0.039). Compared to the non-obese group, the obese group showed a higher proportion of the patients with AA or AG genotypes (64.3% vs. 84.5%, p = 0.001). Conclusions: The A allele of the RANTES gene is associated with obesity and may affect diabetic microvascular complications in patients with T2D for over 15 years.

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