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https://www.readbyqxmd.com/read/29748368/cardiovascular-effects-of-new-oral-glucose-lowering-agents-dpp-4-and-sglt-2-inhibitors
#1
REVIEW
André J Scheen
Cardiovascular disease (CVD) is a major challenge in the management of type 2 diabetes mellitus. Glucose-lowering agents that reduce the risk of major cardiovascular events would be considered a major advance, as recently reported with liraglutide and semaglutide, 2 glucagon-like peptide-1 receptor agonists, and with empagliflozin and canagliflozin, 2 SGLT-2 (sodium-glucose cotransporter type 2) inhibitors, but not with DPP-4 (dipeptidyl peptidase-4) inhibitors. The present review is devoted to CV effects of new oral glucose-lowering agents...
May 11, 2018: Circulation Research
https://www.readbyqxmd.com/read/29519226/postoperative-euglycaemic-diabetic-ketoacidosis-associated-with-sodium-glucose-cotransporter-2-inhibitors-gliflozins-a-report-of-two-cases-and-review-of-the-literature
#2
B Chacko, M Whitley, U Beckmann, K Murray, M Rowley
Sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated euglycaemic diabetic ketoacidosis (euDKA) is a serious and increasingly recognised complication of treatment with this class of oral hypoglycaemic agents and can present a diagnostic challenge, resulting in delayed recognition, inappropriate treatment and potentially life-threatening acidosis. We present two cases of patients developing SGLT2i-associated euDKA in the early postoperative period. We support ceasing SGLT2i for 72 hours preoperatively and would suggest continuing to withhold the medication until oral intake is restored, and recommend a wider awareness of SGLT2i-associated diabetic ketoacidosis (DKA) amongst patients and their healthcare providers with an emphasis on checking ketone levels irrespective of blood glucose levels in the postoperative setting...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29519216/the-good-the-bad-and-the-ugly-sodium-glucose-cotransporter-2-inhibitors-gliflozins-and-perioperative-diabetes
#3
EDITORIAL
R Kerridge, I Whyte, F Prior, J Luu, D A Story
No abstract text is available yet for this article.
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29445145/canagliflozin-mediated-dual-inhibition-of-mitochondrial-glutamate-dehydrogenase-and-complex-i-an-off-target-adverse-effect
#4
Philipp F Secker, Sascha Beneke, Nadja Schlichenmaier, Johannes Delp, Simon Gutbier, Marcel Leist, Daniel R Dietrich
Recent FDA Drug Safety Communications report an increased risk for acute kidney injury in patients treated with the gliflozin class of sodium/glucose co-transport inhibitors indicated for treatment of type 2 diabetes mellitus. To identify a potential rationale for the latter, we used an in vitro human renal proximal tubule epithelial cell model system (RPTEC/TERT1), physiologically representing human renal proximal tubule function. A targeted metabolomics approach, contrasting gliflozins to inhibitors of central carbon metabolism and mitochondrial function, revealed a double mode of action for canagliflozin, but not for its analogs dapagliflozin and empagliflozin...
February 14, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29437648/cardiovascular-outcomes-associated-with-canagliflozin-versus-other-non-gliflozin-antidiabetic-drugs-population-based-cohort-study
#5
Elisabetta Patorno, Allison B Goldfine, Sebastian Schneeweiss, Brendan M Everett, Robert J Glynn, Jun Liu, Seoyoung C Kim
OBJECTIVE: To evaluate the cardiovascular safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor for the treatment of type 2 diabetes mellitus, in direct comparisons with DPP-4 inhibitors (DPP-4i), GLP-1 receptor agonists (GLP-1RA), or sulfonylureas, as used in routine practice. DESIGN: Population based retrospective cohort study. SETTING: Nationwide sample of patients with type 2 diabetes from a large de-identified US commercial healthcare database (Optum Clinformatics Datamart)...
February 6, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29378901/gut-as-an-emerging-organ-for-the-treatment-of-diabetes-focus-on-mechanism-of-action-of-bariatric-and-endoscopic-interventions
#6
REVIEW
Martin Haluzík, Helena Kratochvílová, Denisa Haluzíková, Miloš Mráz
Increasing worldwide prevalence of type 2 diabetes mellitus and its accompanying pathologies such as obesity, arterial hypertension and dyslipidemia represents one of the most important challenges of current medicine. Despite intensive efforts, high percentage of patients with type 2 diabetes does not achieve treatment goals and struggle with increasing body weight and poor glucose control. While novel classes of antidiabetic medications such as incretin-based therapies and gliflozins have some favorable characteristics compared to older antidiabetics, the only therapeutic option shown to substantially modify the progression of diabetes or to achieve its remission is bariatric surgery...
April 2018: Journal of Endocrinology
https://www.readbyqxmd.com/read/29251018/cardiovascular-outcomes-with-canagliflozin-is-it-on-the-canvas
#7
Sheila A Doggrell
Sodium-glucose cotransporter 2 (SGLT2) inhibitors (the 'gliflozins') promote the excretion of glucose from the kidney to lower HbA1c. Empagliflozin was the first gliflozin shown to improve cardiovascular and renal outcomes in subjects with type 2 diabetes and cardiovascular disease. Areas covered: In the Canagliflozin Cardiovascular Assessment Study (CANVAS) Program, there were improvements in the primary cardiovascular and exploratory renal outcomes with canagliflozin, compared to placebo. The safety outcome finding, which was of most interest, was that there was a higher risk of amputation of toes, feet, or legs with canagliflozin than in the placebo group...
February 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29212337/-status-of-pharmacotherapy-in-current-care-of-obese
#8
Petr Sucharda
Weight loss drugs or anti-obesity drugs have a long history but are still far from being successful. Only in two last decades have the drugs been launched, which, when appropriately indicated, may be significantly beneficial to patients in need of weight loss as they are comparably effective to intensive programs to promote changes in eating habits and lifestyles. The combination naltrexone/bupropion is promising for food intake control including the reward mechanism, but the experience with its use has only been short-term...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29211300/fluorine-directed-glycosylation-enables-the-stereocontrolled-synthesis-of-selective-sglt2-inhibitors-for-type-ii-diabetes
#9
Anna Sadurní, Gerald Kehr, Marie Ahlqvist, Johan Wernevik, Helena Peilot Sjögren, Cecilia Kankkonen, Laurent Knerr, Ryan Gilmour
Inhibition of the sodium-glucose co-transporters (SGLT1 and SGLT2) is a validated strategy to address the increasing prevalence of type II diabetes mellitus. However, achieving selective inhibition of human SGLT1 or SGLT2 remains challenging. Orally available small molecule drugs based on the d-glucose core of the natural product Gliflozin have proven to be clinically effective in this regard, effectively impeding glucose reabsorption. Herein, we disclose the influence of molecular editing with fluorine at the C2 position of the pyranose ring of Phlorizin analogues Remogliflozin Etabonate and Dapagliflozin (Farxiga® ) to concurrently direct β-selective glycosylation, as is required for biological efficacy, and enhance aspects of the physicochemical profile...
February 26, 2018: Chemistry: a European Journal
https://www.readbyqxmd.com/read/29148749/glycosyl-cross-coupling-of-anomeric-nucleophiles-scope-mechanism-and-applications-in-the-synthesis-of-aryl-c-glycosides
#10
Feng Zhu, Jacob Rodriguez, Tianyi Yang, Ilia Kevlishvili, Eric Miller, Duk Yi, Sloane O'Neill, Michael J Rourke, Peng Liu, Maciej A Walczak
Stereoselective manipulations at the C1 anomeric position of saccharides are one of the central goals of preparative carbohydrate chemistry. Historically, the majority of reactions forming a bond with anomeric carbon has focused on reactions of nucleophiles with saccharide donors equipped with a leaving group. Here, we describe a novel approach to stereoselective synthesis of C-aryl glycosides capitalizing on the highly stereospecific reaction of anomeric nucleophiles. First, methods for the preparation of anomeric stannanes have been developed and optimized to afford both anomers of common saccharides in high anomeric selectivities...
December 13, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/29144574/sglt-2-inhibitors-and-ketoacidosis-a-disproportionality-analysis-in-the-world-health-organization-s-adverse-drug-reactions-database
#11
Abdel Nasser Ado Moumouni, Perrine Robin, Dominique Hillaire-Buys, Jean-Luc Faillie
SGLT-2 inhibitors, also called gliflozins, are a new class of drugs used in type 2 diabetes. Since their marketing, several cases of ketoacidosis, including life-threatening conditions, were reported with their use. The objective of this study was to investigate the disproportionality of pharmacovigilance reports of ketoacidosis between gliflozins and other drugs used for type 2 diabetes. We performed a case-noncase study within the World Health Organization's pharmacovigilance database, VigiBase. We selected all reports of serious adverse drug reaction associated with a glucose-lowering drug in patients aged 40 years and older, from January 2013 to March 2016...
April 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29127757/-gliflozins-slow-down-the-progression-of-diabetic-kidney-disease
#12
REVIEW
Vladimír Tesař, Jan Vachek
Until recently progression of diabetic kidney disease could have been slowed down only by the inhibition of the renin-angiotensin system. Inhibitors of SGLT2 (sodium-glucose transporter 2) in the proximal tubulus of the kidney induce natriuresis and by the activation of the tubuloglomerular feedback increase the tone of the afferent arteriole and decrease the glomerular pressure. Empagliflozin in the study EMPA-REG Outcome significantly decreased the risk of progression of diabetic kidney disease and further analyses also demonstrated its potent antiproteinuric effect...
December 0: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29127756/-diabetes-mellitus-and-cognitive-disorders-from-the-diabetologists-perspective
#13
Alena Šmahelová
Diabetes mellitus is associated with cognitive impairment which may convert to vascular or neurodegenerative dementia. Impairment of cognitive functions affects patients with type 1 and especially type 2 diabetes, with a number of vascular, metabolic and psychosocial factors involved in its development. As hyperglycemia and hypoglycemia also play an important role, important is the correct strategy of diabetes therapy which utilizes a combination of metformin with modern safe antidiabetics (incretin drugs, gliflozins, insulin analogues)...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29127747/-treatment-strategy-of-type-2%C3%A2-diabetes-used-in-czech-republic-after-metformin-therapy-failure
#14
Štěpán Svačina, Petra Ovesná, Matyáš Kuhn, Martina Nováčková
INTRODUCTION: Type 2 diabetes is an enormous medical problem caused by increasing prevalence of the disease and increasing prevalence of severe chronic complications of diabetes. New ADA/EASD guidelines and also Czech diabetes society guidelines enable effective individual approach to the patient. Goal of the therapy is optimal compensation of diabetes and prevention of acute and chronic complications of diabetes and decrease of mortality. Diabetes therapy is started by education in diet a regime combined with metformin...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28845946/-nephrolithiasis-coexisting-with-type-2-diabetes-current-concept-of-the-features-of-stone-formation-and-the-effects-of-hypoglycemic-therapy-on-lithogenesis
#15
REVIEW
S K Yarovoi, S A Golovanov, M R Khaziakhmetova, O V Dzhalilov
The article analyzes Russian and international literature examining specific features of the pathogenesis of renal stones in the setting of carbohydrate metabolism disorders. The authors outline the renal effects of the main pharmacological groups of oral hypoglycemic drugs regarding metaphylaxis of nephrolithiasis. An increased risk of nephrolithiasis in type 2 diabetes mellitus is realized through hyperuricemia with concurrent urine acidification. Current literature is lacking studies on the effects of oral hypoglycemic drugs on urine properties...
July 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28837279/-cardiorenal-protection-with-sglt2-inhibitors-gliflozins-from-empa-reg-outcome-to-canvas
#16
André J Scheen, Philippe Ernest, Bernard Jandrain
The cardiovascular (CV) and renal protection reported with empagliflozin in EMPA-REG OUTCOME is now confirmed with canagliflozin in CANVAS in patients with type 2 diabetes and high cardiovascular risk: similar and significant reductions in major CV events (-14 vs. -14%), in hospitalisations for heart failure (-35 vs. -33%) and in renal events (-39 vs. -40%). The greater reduction in CV mortality (-38 vs. - 13%) and all-cause mortality (-32 vs. -13%) in EMPA-REG OUTCOME than in CANVAS may be explained by the greater proportion of patients with CV disease (secondary prevention : 99 vs...
August 23, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28837278/-therapeutic-options-for-a-type-2-diabetic-patient-not-well-controlled-with-metformin-plus-basal-insulin
#17
André J Scheen, Nicolas Paquot
In a patient with type 2 diabetes not well controlled with a basal insulin - metformin combination, several therapeutic options may be considered: intensifying insulin therapy with different schemes (appropriate titration using a more favourable basal insulin analogue, adding one, two or three rapid-acting insulin analogues, shift to two or three premix insulin injections), adding a dipeptidyl peptidase-4 inhibitor (gliptin) or an inhibitor of sodium-glucose cotransporters type 2 (gliflozin), or combining a glucagon-like peptide-1 receptor agonist with basal insulin...
August 23, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28837277/-dpp-4-or-sglt2-inhibitor-added-to-metformin-alone-in-type-2-diabetes
#18
Nicolas Paquot, André J Scheen
After failure of a monotherapy with metformin, dipeptidyl peptidase-4 inhibitors (gliptins) and sodium-glucose cotransporters type 2 (gliflozins) offer an alternative to the add-on of a sulphonylurea, especially in diabetic patients at risk of hypoglycaemia. The choice between a gliptin and a gliflozin may be guided by the individual patient characteristics : rather a gliptin in a patient without obesity or severe hyperglycaemia, in an elderly patient, with a frailty profile or with renal impairment; rather a gliflozin in an obese patient, with hypertension, hyperuricaemia, antecedents of cardiovascular disease (especially heart failure), without advanced renal insufficiency and with a low risk of urinary/genital infections or events linked to dehydration such as hypotension...
August 23, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28790046/gliflozins-and-reducing-cardiovascular-events-and-other-stories
#19
(no author information available yet)
No abstract text is available yet for this article.
August 8, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28760223/clinical-profile-of-patients-with-type-2-diabetes-mellitus-treated-with-sodium-glucose-cotransporter-2-inhibitors-and-experience-in-real-world-clinical-practice-in-spain
#20
Gabriel Cuatrecasas, Fernando Goñi-Goicoechea
The main aim of the treatment of type 2 diabetes is overall control of cardiovascular risk factors. Almost 50% of patients with type 2 diabetes do not achieve glycaemic targets, and a much higher percentage do not achieve weight and blood pressure targets, despite the therapeutic arsenal that has appeared in the last decade for the treatment of this disease. In addition, antidiabetic secretatogues and insulin are associated with weight gain and an increased risk of hyperglycaemic episodes. Clinical practice guidelines recommend sodium-glucose cotransporter-2 inhibitors (SGLT2i) as an alternative in the same therapeutic step as the other options after initiation of metformin therapy...
November 2016: Medicina Clínica
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