SGLT-2 Inhibition: Novel Therapeutics for Reno-and Cardioprotection in Diabetes Mellitus

2019 ◽  
Vol 15 (5) ◽  
pp. 349-356 ◽  
Author(s):  
Angus Gill ◽  
Stephen P. Gray ◽  
Karin A. Jandeleit-Dahm ◽  
Anna M.D. Watson
Keyword(s):  
Sympathetic Nerve Activity ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Preclinical Research ◽  
Type 2 Diabetic Patients ◽  
Nerve Activity ◽  
Current State ◽  
Glucose Reabsorption ◽  
Type 2 Diabetic

Background: The sodium glucose co-transporter 2 (SGLT2) is primarily located within S1 of the renal proximal tubule being responsible for approximately 90% of glucose re-uptake in the kidney. Inhibition of SGLT2 is an exciting new pharmacological approach for the reduction of blood glucose in type 2 diabetic patients via inhibition of tubular glucose reabsorption. In addition to lowering glucose, this group of drugs has shown significant cardiovascular and renal protective effects. Conclusion: This review aims to outline the current state of preclinical research and clinical trials for different SGLT2 inhibitors and outline some of the proposed mechanisms of action, including possible effects on sympathetic nerve activity, which may contribute to the unexpected beneficial cardiovascular and reno-protective effects of this class of compounds.

scholarly journals Association between Statin Use and Sensorineural Hearing Loss in Type 2 Diabetic Patients: A Hospital-Based Study

2021 ◽  
Vol 14 (11) ◽  
pp. 1076
Author(s):  
Hye-Won Han ◽  
Jeong Yee ◽  
Yoon-Hee Park ◽  
Hye-Sun Gwak
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic ◽  
Age And Sex ◽  
Statin Use

Background: Statins have emerged as protective agents against sensorineural hearing loss (SNHL) associated with dyslipidemia, but the effects of statins on SNHL are not consistent. The purpose of this study was to investigate the association between statin use and the risk of SNHL using a hospital cohort. Methods: This nested case-control study included type 2 diabetic patients over the age of 18 years without a history of hearing loss. Of these, 1379 patients newly diagnosed with SNHL or tinnitus were classified as cases, and 5512 patients matched to the cases based on age, sex, and index year were classified as controls. Chi-squared tests were used to compare categorical variables between the two groups. Odds ratios (ORs) and adjusted odds ratios (AOR) were calculated from univariate and multivariable unconditional logistic regression analyses, respectively. Results: There was a significant difference in the prevalence of statin use between the cases and controls (53.7% vs. 61.2%, respectively; p < 0.001). The use of statins in type 2 diabetic patients significantly reduced the risk of SNHL or tinnitus by 24.8% (95% CI 14.2–34.1%, p < 0.001) after controlling for confounders. Similar results were found for the association between statin use and SNHL (AOR = 0.706; 95% CI 0.616–0.811, p < 0.001). The protective effects of statins against SNHL were consistent regardless of age and sex. Conclusion: The use of statins for type 2 diabetic patients was significantly associated with a reduced risk of SNHL, regardless of age and sex. Further studies are needed, especially large cohort studies, to evaluate the long-term protective effects of statins.

scholarly journals Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes

2020 ◽  
Author(s):  
Mitsunobu Kubota ◽  
Eri SHiroyama ◽  
Kanako Tanaka ◽  
Yoko Yoshii
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Renal Protection ◽  
Short Term ◽  
Type 2 Diabetic Patients ◽  
Before And After ◽  
Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the chart information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in the nephropathy stage 2 and 3 groups. UACR decreased only in the group in which blood pressure, body weight, and HbA1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that SGLT-2 inhibitors are independent of renin-angiotensin system (RAS) inhibitors, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

scholarly journals Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes: a retrospective study

2020 ◽  
Author(s):  
Mitsunobu Kubota ◽  
Eri Shiroyama ◽  
Kanako Tanaka ◽  
Yoko Yoshii
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Renal Protection ◽  
Short Term ◽  
Type 2 Diabetic Patients ◽  
Before And After ◽  
Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the medical record information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in nephropathy patients with microalbuminuria or overt albuminuria. UACR decreased only in the group in which blood pressure, body weight, and hemoglobin A1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that the renoprotective effects of SGLT-2 inhibitors are more likely to be exerted in diabetic nephropathy patients who have advanced to at least microalbuminuria stage, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

scholarly journals Short-term Renoprotective Effect of SGLT-2 Inhibitor for Renal Function and Albuminuria in Type 2 Diabetes: A Retrospective Study

2020 ◽  
Author(s):  
Mitsunobu Kubota ◽  
Eri Shiroyama ◽  
Kanako Tanaka ◽  
Yoko Yoshii
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Renal Protection ◽  
Short Term ◽  
Type 2 Diabetic Patients ◽  
Before And After ◽  
Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the medical record information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in nephropathy patients with microalbuminuria or overt albuminuria. UACR decreased only in the group in which blood pressure, body weight, and HbA1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that the renoprotective effects of SGLT-2 inhibitors are more likely to be exerted in diabetic nephropathy patients who have advanced to at least microalbuminuria stage, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

scholarly journals Microcirculatory dopplerography as a method to evaluate drugs endothelial protective properties in type 2 diabetic patients

2018 ◽  
Vol 17 (3) ◽  
pp. 120-128 ◽  
Author(s):  
A. V. Simanenkova ◽  
M. N. Makarova ◽  
L. V. Vasina ◽  
M. I. Butomo ◽  
E. V. Shlyakhto ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Type 2 Diabetic Patients ◽  
Protective Properties ◽  
Circulating Markers ◽  
Group 2 ◽  
Type 2 Diabetic ◽  
Group 1

Objective - to identify the most accurate way of drugs endothelial protective properties evaluation. Material and methods. Blood endothelin-1 (E) and acetylcholine-induced endothelial dependent vasodilation (EDV) were measured for 9 months in type 2 diabetic patients receiving either metformin (MET) (group 1) or MET and liraglutide (LIR) (group 2). Results. E was normal in group 1 at baseline and decreased only with glycaemia decline, in group 2 it was primarily increased and declined independently on glycaemia dynamics. In both groups E normalized in 6 months. EDV was impaired primarily in groups 1 and 2 and normalized only in group 2 in 9 months. Conclusions. LIR improves endothelial function, independently on glycaemia. Dopplerography in more accurate in drugs endothelial protective effects evaluation than circulating markers.

Sign in / Sign up

Export Citation Format

Share Document