scholarly journals Pharmacokinetic characteristics and morphometric effects of sodium-glucose contransporter-2 inhibitors in men and women with type 2 diabetes mellitus (literature review and own results)

2021 ◽  
Vol 17 (4) ◽  
pp. 293-303
Author(s):  
O.V. Prybyla
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Composition ◽  
Lipid Profile ◽  
Plasma Lipid ◽  
Cardiovascular Complications ◽  
Men And Women ◽  
Sodium Glucose Cotransporter

Background. According to the latest international clinical guidelines, gliflozins — sodium-glucose cotransporter-2 inhibitors — are indicated as oral antidiabetic drugs of second-third-line therapy in type 2 diabetes mellitus. Due to insulin-independent stimulation of glucosuria, gliflozins have extraglycemic effects such as weight loss, improved adipose tissue distribution, better plasma lipid profile, and decreased uricemia that in generally reduce the risk of cardiovascular complications. The purpose of this study was to evaluate the effectiveness of dapagliflozin in the treatment of men and women with type 2 diabetes mellitus with a metabo­lically unhealthy phenotype. Materials and methods. The study included 17 individuals with diabetes mellitus type 2 (11 men and 6 women), aged 58.0 ± 1.7 years (95% confidence interval 53–62), whose body composition was evaluated by bioelectric impedance using a Tanita analyzer BC-545N (Japan). Patients received therapy with dapagliflozin, antihypertensive and antihyperlipidemic drugs (statins). Results. A three-month use of dapagliflozin in a dose of 10 mg once daily caused a decrease in body mass index, waist circumference, improvement of body composition, in parti­cular a reduction in total body fat (the significance of changes was determined using a paired t-test). No significant changes in muscle and bone mass, body composition, lipid profile, and uricemia level were observed. The group of women, in contrast to men, had a decreased level of visceral fat, which was accompanied by an improvement in the body’s water supply, and a reduction in the estimated metabolic age. Conclusions. Treatment of type 2 diabetes patients with sodium-glucose cotransporter-2 inhibitors for 3 months has reduced the degree of obesity and improved some indices of body composition. Confirmation of this trend can be obtained in further observations.

scholarly journals Effectiveness of atorvastatin therapy in patients with arterial hypertension, diabetic nephropathy and diabetes mellitus type 2

2019 ◽  
pp. 105-110
Author(s):  
O. M. Chernatska ◽  
T. S. Mazur ◽  
N. V. Demikhova ◽  
O. M. Vlasenko ◽  
T. M. Rudenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Arterial Hypertension ◽  
Lipid Profile ◽  
Cardiovascular Complications ◽  
Actual Problem ◽  
Type 2 Dm

The actual problem of internal medicine is the managemen of patients with comorbid pathology. Arterial hypertension (AH) is determined in about quarter of the population in the world. Moreover, the coexistence of AH and type 2 diabetes mellitus (DM) connected with the increased risk of cardiovascular complications (CVC) compared with patients with AH. In principle dyslipidemia is the common link between AH and type 2 DM, which need the correction. No doubt that reduction of atherogenic and increase of anti atherogenic lipoproteins is necessary for persons with comorbid pathology. The objective of our study was the assessment of atorvastatin treatment in patients with AH, diabetic nephropathy and type 2 DM. We obtained 96 patients with AH, diabetic nephropathy and type 2 DM (І group), 25 persons with AH (ІІ group), 15 conditionally healthy individuals. Persons had CVC in the past. For patients from the І and ІІ group CVC were defined accordingly (4,97 ± 0,20) years and (4,10 ± 0,05) years ago (P = 0,0291). The duration of AH is (8,1 ± 0,2) years for the І group and (8,90 ± 0,13) years for the ІІ group. The levels of lipid profile spectrum were determined according to the methods of W. T. Friedewald. The results of investigation were analyzed with the help of Microsoft Excel 2016. Correction of lipid profile spectrum is the important part of multipurpose treatment for persons with coexistent pathology. All patients were treated by atorvastatin (10−40 mg/day) during 6 months in a complex therapy. The target levels of general cholesterol during 6 months were presented in 30 persons (31.91 %), low density lipoproteids – in 10 persons (10.64 %), high density lipoproteids – in 26 persons (27.66 %), triglycerides – in 34 persons (36.17 %) among patients with AH, diabetic nephropathy and type 2 DM. In conclusion, it is advisable to prescribe atorvastatin (10–40 mg/day) for correction of dyslipidemia, reduction of proatherogenic orientation, prevention of atherosclerotic process manifestation and cardiovascular complications in patients with AH with diabetic nephropathy and type 2 diabetes mellitus.

scholarly journals Body Composition and Diabetes

2021 ◽  
Vol 22 (4) ◽  
pp. 238-243
Author(s):  
Hye Jin Yoo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Composition ◽  
Diagnostic Criteria ◽  
Metabolic Diseases ◽  
Men And Women ◽  
Anthropometric Indicators ◽  
Underlying Mechanisms

Representative body composition related to metabolic diseases in our body include fats and muscles, and accumulation of abdominal fats and loss of muscles caused by aging are the main causes of type 2 diabetes mellitus. Such changes in body composition vary according to sex and age; in particular, women exhibit significant changes, especially during menopause. Therefore it is necessary to determine new anthropometric indicators that reflect differences in muscles and fats mass changes caused by aging, as well as their distributions, and to establish diagnostic criteria for stratifying the risks of metabolic diseases in both men and women. This article summarizes the underlying mechanisms and recent epidemiological findings that support how muscles decrease and visceral fats increase the risk of type 2 diabetes mellitus.

Trabecular Bone Score in Thais with or without Type 2 Diabetes

2020 ◽  
Vol 103 (11) ◽  
pp. 1131-1137
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fracture Risk ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Mineral Density ◽  
Men And Women

Background: When compared to people without type 2 diabetes mellitus (T2DM), people with T2DM have an increase in fracture risk despite having higher bone mineral density (BMD). Many studies in Caucasians demonstrated that trabecular bone score (TBS) is lower in people with T2DM than those without. The utility of TBS as a fracture risk assessment tool in Asians with T2DM is currently unclear. Objective: To compared lumbar spine (LS) BMD and TBS in Thais with or without T2DM and investigate the correlation between TBS and hemoglobin A1c (HbA1c) and diabetes duration in participants with T2DM. Materials and Methods: The present study was a cross-sectional study that included 97 participants with T2DM (37 men and 60 women) and 342 participants without T2DM (174 men and 168 women). LS-BMD and TBS were obtained. Results: Men and women with T2DM were older and had higher body mass index (BMI). Men with T2DM had significant higher LS-BMD (1.051±0.166 versus 0.972±0.125, p=0.009) and non-significant lower TBS (1.333±0.084 versus 1.365±0.096, p=0.055) than those without. Similarly, women with T2DM had significant higher LS-BMD (0.995±0.155 versus 0.949±0.124, p=0.021) and lower TBS (1.292±0.105 versus 1.382±0.096, p<0.001). After adjusting for age and BMI, T2DM predicted higher BMD in men (p<0.001), but not in women (p=0.143). T2DM was not associated with TBS after adjusting for age and BMI in both genders (p=0.403 and p=0.151 in men and women, respectively). TBS did not correlate with HbA1c in both genders. However, TBS was non-significantly associated with diabetes duration in women (p=0.073), but not in men (p=0.639). Conclusion: T2DM significantly predicted higher LS-BMD only in men and was not independently associated with TBS in both genders. These data highlighted that, in T2DM, there was some variation in the clinical usefulness of BMD and TBS in predicting osteoporotic fractures with regard to clinical characteristic of participants. Keywords: Bone mineral density, Type 2 diabetes mellitus, Trabecular bone score

Mechanisms of Protective Effects of SGLT2 Inhibitors in Cardiovascular Disease and Renal Dysfunction

2019 ◽  
Vol 19 (20) ◽  
pp. 1818-1849 ◽  
Author(s):  
Ban Liu ◽  
Yuliang Wang ◽  
Yangyang Zhang ◽  
Biao Yan
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Dysfunction ◽  
Sglt2 Inhibitors ◽  
Sodium Glucose Cotransporter ◽  
Glucose Reabsorption ◽  
Renal Glucose Reabsorption

: Type 2 diabetes mellitus is one of the most common forms of the disease worldwide. Hyperglycemia and insulin resistance play key roles in type 2 diabetes mellitus. Renal glucose reabsorption is an essential feature in glycaemic control. Kidneys filter 160 g of glucose daily in healthy subjects under euglycaemic conditions. The expanding epidemic of diabetes leads to a prevalence of diabetes-related cardiovascular disorders, in particular, heart failure and renal dysfunction. Cellular glucose uptake is a fundamental process for homeostasis, growth, and metabolism. In humans, three families of glucose transporters have been identified, including the glucose facilitators GLUTs, the sodium-glucose cotransporter SGLTs, and the recently identified SWEETs. Structures of the major isoforms of all three families were studied. Sodium-glucose cotransporter (SGLT2) provides most of the capacity for renal glucose reabsorption in the early proximal tubule. A number of cardiovascular outcome trials in patients with type 2 diabetes have been studied with SGLT2 inhibitors reducing cardiovascular morbidity and mortality. : The current review article summarises these aspects and discusses possible mechanisms with SGLT2 inhibitors in protecting heart failure and renal dysfunction in diabetic patients. Through glucosuria, SGLT2 inhibitors reduce body weight and body fat, and shift substrate utilisation from carbohydrates to lipids and, possibly, ketone bodies. These pleiotropic effects of SGLT2 inhibitors are likely to have contributed to the results of the EMPA-REG OUTCOME trial in which the SGLT2 inhibitor, empagliflozin, slowed down the progression of chronic kidney disease and reduced major adverse cardiovascular events in high-risk individuals with type 2 diabetes. This review discusses the role of SGLT2 in the physiology and pathophysiology of renal glucose reabsorption and outlines the unexpected logic of inhibiting SGLT2 in the diabetic kidney.

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