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Diabetes sglt2

Ben Li, Konrad Salata, Charles de Mestral, Mohamad A Hussain, Badr A Aljabri, Thomas F Lindsay, Subodh Verma, Mohammed Al-Omran
BACKGROUND: Vascular surgeons have a central role in managing peripheral artery disease (PAD). This study assessed their knowledge, attitudes, and behaviours regarding pharmacologic risk reduction in PAD and results were compared to a similar 2004 survey conducted by our group. METHODS: An online questionnaire was administered to 161 active members of the Canadian Society for Vascular Surgery. RESULTS: Forty-eight participants (30%) completed the survey...
February 13, 2019: Annals of Vascular Surgery
Wataru Ogawa, Yushi Hirota
Sodium-glucose cotransporter 2 (SGLT2) inhibitors, the newest class of oral antidiabetes drugs for type 2 diabetes, ameliorate hyperglycemia primarily by preventing the reabsorption of urinary glucose in the kidneys. Within less than 5 years, abundant evidence for favorable characteristics of SGLT2 inhibitors has accumulated. Of note, large-scale clinical trials have revealed that these drugs prevent cardiovascular events, at least in cohorts at high risk for such events, and that they slow the decline in renal function...
February 15, 2019: Journal of Diabetes Investigation
A Phrommintikul, W Wongcharoen, S Kumfu, T Jaiwongkam, S Gunaparn, S C Chattipakorn, N Chattipakorn
AIMS: SGLT2 inhibitors have been shown to reduce cardiovascular (CV) events and heart failure (HF) in type 2 diabetic (T2D) patients with high CV risk. DPP-4 inhibitors showed neutral effects and may increase risk of HF. We aimed to compare cardiometabolic effects of dapagliflozin and vildagliptin in T2D patients with coronary artery disease (CAD). METHODS: Forty-nine T2D patients with CAD were randomly assigned to dapagliflozin (n=25) or vildagliptin (n=24) for 6 months in a double-blind fashion...
February 14, 2019: British Journal of Clinical Pharmacology
Lindsey Burggraaff, Paul Oranje, Robin Gouka, Pieter van der Pijl, Marian Geldof, Herman W T van Vlijmen, Adriaan P IJzerman, Gerard J P van Westen
Sodium-dependent glucose co-transporter 1 (SGLT1) is a solute carrier responsible for active glucose absorption. SGLT1 is present in both the renal tubules and small intestine. In contrast, the closely related sodium-dependent glucose co-transporter 2 (SGLT2), a protein that is targeted in the treatment of diabetes type II, is only expressed in the renal tubules. Although dual inhibitors for both SGLT1 and SGLT2 have been developed, no drugs on the market are targeted at decreasing dietary glucose uptake by SGLT1 in the gastrointestinal tract...
February 14, 2019: Journal of Cheminformatics
Prakash Deedwania, Tushar Acharya
Diabetes mellitus is a major risk factor for cardiovascular (CV) disease. Conversely, CV disease is responsible for a majority of the deaths in patients with diabetes. Many drug trials have concentrated on blood glucose (hemoglobin A1c ) reduction. This strategy, while reducing microvascular outcomes like nephropathy and neuropathy, has little or no effect on reducing macrovascular events like heart attack, stroke, and heart failure. It has been postulated that hypoglycemia may counterbalance some of the beneficial effects of anti-hyperglycemic agents, but this is not proven...
February 15, 2019: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
A G Unnikrishnan, Sanjay Kalra, Vedavati Purandare, Hardik Vasnawala
Diabetes is a metabolic disorder characterized by hyperglycemia and is associated with several comorbidities and complications. Genital infection is one such complication that is often associated with diabetes mellitus (DM). Even though abnormalities in immune system, high urine glucose, and bladder dysfunction are important contributors for the increased risk of genitourinary symptoms, yet the possible role of pharmacologically induced glucosuria cannot be completely overlooked in such patients. There are various classes of medications to control blood glucose levels...
November 2018: Indian Journal of Endocrinology and Metabolism
Sanjay Kalra, Jothydev Kesavadev, Manoj Chadha, G Vijaya Kumar
Involvement of multiple physiological pathways and complex pathogenesis is responsible for the onset and progression of type 2 diabetes mellitus (T2DM). Since it is difficult to manage multiple pathophysiological defects by monotherapy, a combination therapy with two or more oral antidiabetic agents (OADs) may help achieve euglycemia in T2DM patients. Choice of OADs is difficult with growing armamentarium of antidiabetic therapy. Ideally, drug combination should aim at reversal of known pathogenic abnormalities and demonstrate improvement in the overall metabolic health rather than simply reduce glycosylated hemoglobin (HbA1c) levels...
November 2018: Indian Journal of Endocrinology and Metabolism
Shanti Pittampalli, Satya Upadyayula, Hema Madhuri Mekala, Steven Lippmann
Health care providers should carefully assess patients with diabetes mellitus before prescribing sodium-glucose cotransporter 2 inhibitor medications and monitor for adverse effects.
July 2018: Federal Practitioner: for the Health Care Professionals of the VA, DoD, and PHS
Clifford J Bailey
Sodium/glucose co-transporter-2 (SGLT2) inhibitors, which lower blood glucose by increasing renal glucose elimination have been shown to reduce the risk of adverse cardiovascular (CV) and renal events in type 2 diabetes. This has been ascribed in part to haemodynamic changes, body weight reduction and several possible effects on myocardial, endothelial and tubulo-glomerular functions as well as reduced glucotoxicity. This review evaluates evidence that an effect of SGLT2 inhibitors to lower uric acid may also contribute to reduced cardio-renal risk...
February 14, 2019: Diabetes, Obesity & Metabolism
Athena Philis-Tsimikas, Liana K Billings, Robert Busch, Cristobal Morales Portillo, Rakesh Sahay, Natalie Halladin, Sarah Eggert, Kamilla Begtrup, Stewart Harris
AIMS: Progression of type 2 diabetes (T2D) necessitates intensification, often involving sequential combination of oral antidiabetic drugs (OADs) before initiation of insulin-based therapy. The DUAL IX trial ( NCT02773368) investigated the efficacy and safety of insulin degludec/liraglutide (IDegLira), vs insulin glargine 100 units/mL (IGlar U100), as add-on to sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy. MATERIALS AND METHODS: In this 26-week, Phase 3b, open-label, parallel-group, treat-to-target trial, conducted at 74 sites in 11 countries, insulin-naïve patients ≥18 years with HbA1c 7...
February 13, 2019: Diabetes, Obesity & Metabolism
Yunwen Xu, Scott J Pilla, G Caleb Alexander, Irene B Murimi
BACKGROUND: Clinical guidelines recommend that metformin be continued after insulin is initiated among patients with type 2 diabetes, yet little is known regarding how often metformin or other non-insulin diabetes medications are continued in this setting. METHODS: We conducted a retrospective cohort study to characterize rates and use patterns of six classes of non-insulin diabetes medications: biguanides (metformin), sulfonylureas, thiazolidinediones (TZDs), glucagon-like peptide 1 receptor agonists (GLP1 receptor agonists), dipeptidyl peptidase 4 inhibitors (DPP4 inhibitors), and sodium-glucose co-transporter inhibitors (SGLT2 inhibitors), among patients with type 2 diabetes initiating insulin...
2019: PloS One
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACE = American College of Endocrinology; ACEI = angiotensin-converting enzyme inhibitor; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ARB = angiotensin II receptor blocker; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CGM = continuous glucose monitoring; CHD = coronary heart disease; CKD = chronic kidney disease; DKA = diabetic ketoacidosis; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; EPA = eicosapentaenoic acid; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density-lipoprotein cholesterol; HeFH = heterozygous familial hypercholesterolemia; LDL-C = low-density-lipoprotein cholesterol; LDL-P = low-density-lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; PCSK9 = proprotein convertase subtilisin-kexin type 9 serine protease; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium-glucose cotransporter 2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione...
January 2019: Endocrine Practice
Ghulam Abbas, Ahmed Al Harrasi, Hidayat Hussain, Ahmed Hamaed, Claudiu T Supuran
Diabetes mellitus is a chronic metabolic disorder which is rapidly spreading worldwide. It is characterized by persistent elevated blood glucose level above normal values (hyperglycemia) due to defect in either insulin secretion or in insulin action or both of them. Currently approved oral synthetic antidiabetic drugs such as biguanides, thiazolidinediones, sulfonylureas, and meglitinides have shown undesirable side effects. Therefore, newer approaches and targets for the management of diabetes mellitus are highly desirable...
February 4, 2019: Bioorganic Chemistry
Liang Cheng, Yun-Yun Li, Hu Wen, Feng Bai, Hai-Rong Hao, Wei-Nan Yu, Xiao-Ming Mao
AIM: To evaluate the association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and risk of bone fractures in patients with type 2 diabetes mellitus (T2DM). METHODS: A systematic literature search conducted of PubMed, Embase, the Cochrane Library and Web of Science from inception up to 31 August 2018 identified all eligible randomized controlled trials (RCTs). The following data were extracted from each study: first author; year of publication; sample size; patient characteristics; study design; intervention drug; control drug; follow-up durations; and incident bone-fracture events...
February 6, 2019: Diabetes & Metabolism
Pieter Martens, Joyce Janssens, Jobbe Ramaekers, Matthias Dupont, Wilfried Mullens
BACKGROUND: The choice of glucose lowering agent in heart failure (HF)-patients can have a strong effect on HF-related adverse events, with some classes increasing and other classes reducing the risk. Little data is available about the choice of glucose lowering agents in HF-patients with type-2-diabetes. METHODS: We performed a cross-sectional single centre point analysis of all patients with both a diagnoses of HF and type-2-diabetes followed in a tertiary HF-clinic...
February 8, 2019: Acta Cardiologica
Damilola D Adingupu, Sven O Göpel, Julia Grönros, Margareta Behrendt, Matus Sotak, Tasso Miliotis, Ulrika Dahlqvist, Li-Ming Gan, Ann-Cathrine Jönsson-Rylander
BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) is the first class of anti-diabetes treatment that reduces mortality and risk for hospitalization due to heart failure. In clinical studies it has been shown that SGLT2i's promote a general shift to fasting state metabolism characterized by reduced body weight and blood glucose, increase in glucagon/insulin ratio and modest increase in blood ketone levels. Therefore, we investigated the connection between metabolic changes and cardiovascular function in the ob/ob-/- mice; a rodent model of early diabetes with specific focus on coronary microvascular function...
February 7, 2019: Cardiovascular Diabetology
Tuba M Ansary, Daisuke Nakano, Akira Nishiyama
The renin-angiotensin system (RAS) plays an important role in regulating body fluids and blood pressure. However, inappropriate activation of the RAS contributes to the pathogenesis of cardiovascular and renal diseases. Recently, sodium glucose cotransporter 2 (SGLT2) inhibitors have been used as anti-diabetic agents. SGLT2 inhibitors induce glycosuria and improve hyperglycemia by inhibiting urinary reabsorption of glucose. However, in the early stages of treatment, these inhibitors frequently cause polyuria and natriuresis, which potentially activate the RAS...
February 1, 2019: International Journal of Molecular Sciences
Yoko Koike, Shin-Ichiro Shirabe, Hajime Maeda, Ayako Yoshimoto, Keiko Arai, Atsushi Kumakura, Koichi Hirao, Yasuo Terauchi
AIMS: Information on the clinical efficacy of SGLT2 inhibitors in the Japanese population is limited. The aim of this single-arm, single-center, open-label study was to confirm the body weight- and fat mass-lowering effects of canagliflozin (CANA) and the accompanying improvement in insulin resistance in Japanese patients with Type 2 diabetes mellitus (T2DM). METHODS: Thirty-eight patients were enrolled and administered 100 mg CANA once daily for 24 weeks. Blood and anthropometric parameters were examined before and after treatment...
February 1, 2019: Diabetes Research and Clinical Practice
Steven G Chrysant, George S Chrysant
OBJECTIVES: Obesity has risen in the US and worldwide, and has become a major risk factor for type 2 diabetes mellitus (T2DM), hypertension, cardiovascular disease, and heart failure (HF), mostly HF with preserved ejection fraction (HFpEF). Also, the prevalence of HF is quite high in the US accounting for 6.6 million adults at present and is projected to reach 8.5 million by the year 2030 and is equally divided between HFpEF and heart failure reduced ejection fraction (HFrEF). Patients with HFpEF are resistant to treatment with drugs usually used for the treatment of HFrEF, but the reasons for this resistance are not clearly known...
February 4, 2019: Hospital Practice (Minneapolis)
Hongmei Wang, Jiadan Yang, Xi Chen, Feng Qiu, Juan Li
PURPOSE: The aim of this study was to systematically evaluate the effect of sodium-glucose cotransporter 2 (SGLT2) inhibitor monotherapy on the weight of patients with type 2 diabetes mellitus (T2DM) and to compare different SGLT2 inhibitors with other oral glucose-lowering medications. METHODS: PubMed, EMBASE, Cochrane Library, and the Web site were searched for relevant randomized controlled trials. Patients with T2DM in the included studies were administered SGLT2 inhibitor monotherapy for at least 12 weeks...
January 30, 2019: Clinical Therapeutics
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