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https://www.readbyqxmd.com/read/28102030/impact-of-sodium-glucose-cotransporter-2-inhibitors-on-nonglycemic-outcomes-in-patients-with-type-2-diabetes
#1
Jennifer M Trujillo, Wesley A Nuffer
The efficacy of the sodium-glucose cotransporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, and empagliflozin in reducing hyperglycemia in patients with type 2 diabetes is well documented. In addition, positive effects have been observed with these agents on nonglycemic variables, such as reductions in body weight and blood pressure, which may confer additional health benefits. SGLT2 inhibitors are also associated with evidence of renal-protecting benefits. Furthermore, during the landmark Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) trial, a substantial reduction in major adverse cardiovascular outcomes was demonstrated with empagliflozin therapy...
January 19, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28099783/ketosis-and-diabetic-ketoacidosis-in-response-to-sglt2-inhibitors-basic-mechanisms-and-therapeutic-perspectives
#2
REVIEW
Hongyu Qiu, Aleksandra Novikov, Volker Vallon
Inhibitors of the sodium-glucose cotransporter SGLT2 are a new class of anti-hyperglycemic drugs that have been approved for the treatment of type 2 diabetes mellitus (T2DM). These drugs inhibit glucose reabsorption in the proximal tubules of the kidney thereby enhancing glucosuria and lowering blood glucose levels. Additional consequences and benefits include a reduction in body weight, uric acid levels, and blood pressure. Moreover, SGLT2 inhibition can have protective effects on the kidney and cardiovascular system in patients with T2DM and high cardiovascular risk...
January 18, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28090050/euglycemic-diabetic-ketoacidosis-with-persistent-diuresis-treated-with-canagliflozin
#3
Junichiro Adachi, Yuusuke Inaba, Chisato Maki
Diabetic ketoacidosis is characterized by hyperglycemia, anion-gap acidosis, and increased plasma ketones. After the resolution of hyperglycemia, persistent diuresis is rare. We herein report the case of a 27-year-old Asian woman with type 2 diabetes who was treated with a sodium-glucose cotransporter 2 (SGLT2) inhibitor (canagliflozin) who developed euglycemic diabetic ketoacidosis and persistent diuresis in the absence of hyperglycemia. Physicians should consider euglycemic diabetic ketoacidosis in the differential diagnosis of patients treated with SGLT2 inhibitors...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28003053/sglt2-inhibitor-associated-diabetic-ketoacidosis-clinical-review-and-recommendations-for-prevention-and-diagnosis
#4
REVIEW
Ronald M Goldenberg, Lori D Berard, Alice Y Y Cheng, Jeremy D Gilbert, Subodh Verma, Vincent C Woo, Jean-François Yale
PURPOSE: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents available on the market. Regulator warnings and concerns regarding the risk of developing diabetic ketoacidosis (DKA), however, have dampened enthusiasm for the class despite the combined glycemic, blood pressure, and occasional weight benefits of SGLT2 inhibitors. With the goal of improving patient safety, a cross-Canada expert panel and writing group were convened to review the evidence to-date on reported SGLT2 inhibitor-related DKA incidents and to offer recommendations for preventing and recognizing patients with SGLT2 inhibitor-associated DKA...
December 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27990776/sglt2-inhibitor-use-and-dietary-carbohydrate-intake-in-japanese-individuals-with-type-2-diabetes-a-randomized-open-label-3-arm-parallel-comparative-exploratory-study
#5
Daisuke Yabe, Masahiro Iwasaki, Hitoshi Kuwata, Takuya Haraguchi, Yoshiyuki Hamamoto, Takeshi Kurose, Kiminobu Sumita, Hitoshi Yamazato, Shigeto Kanada, Yutaka Seino
This study investigated safety and efficacy of the SGLT2 inhibitor luseogliflozin under differing carbohydrate intake in Japanese individuals with type 2 diabetes (T2D). Subjects were randomly assigned to three carbohydrate-adjusted meals for 14 days (Days 1-14) [HC-HGI, 55% total energy carbohydrate (TEC) and high glycemic index (GI); HC-LGI, 55% TEC and low GI; and LC-HGI, 40% TEC and high GI]. All subjects received luseogliflozin for the last 7 days (Days 8-14); continuous glucose monitoring (CGM) before and after luseogliflozin treatment (Days 5-8 and Days 12-15); and blood tests on Days 1, 8, and 15...
December 19, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27977934/longer-term-safety-and-tolerability-of-canagliflozin-in-patients-with-type-2-diabetes-a-pooled-analysis
#6
Rong Qiu, Dainius Balis, John Xie, Michael J Davies, Mehul Desai, Gary Meininger
OBJECTIVE: To evaluate the longer-term safety of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes mellitus (T2DM). METHODS: The safety/tolerability of canagliflozin 100 and 300 mg were assessed using data pooled from seven placebo- and active-controlled studies of 52-104 weeks in duration that enrolled a broad range of patients with T2DM (N = 5598). Canagliflozin 100 and 300 mg as monotherapy or in combination with various background antihyperglycemic agents (AHAs) were compared with pooled non-canagliflozin treatments (i...
March 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27931088/sglt2-inhibitors-a-systematic-review-of-diabetic-ketoacidosis-and-related-risk-factors-in-the-primary-literature
#7
Kelly R Burke, Christine A Schumacher, Spencer E Harpe
STUDY OBJECTIVE: Currently only minimal information is available regarding risk factors for the development of sodium glucose cotransporter-2 inhibitor (SGLT2i)-related diabetic ketoacidosis (DKA). We aim to identify individual patient characteristics associated with cases of SGLT2i-related DKA to better describe potential risk factors. DESIGN: Systematic review of primary literature. PATIENTS: Thirty-four case reports of patients with type 1 and type 2 diabetes mellitus who developed DKA while receiving an SGLT2i...
December 8, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27908315/-life-threatening-ketoacidosis-in-a-25-year-old-woman-treated-with-sodium-glucose-cotransporter-2-inhibitor
#8
Mats Jacob Hermansson Lindberg, Frans Brandt Kristensen, Alev Yildiz
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27867961/cardio-renal-protection-with-empagliflozin
#9
Richard J MacIsaac, George Jerums, Elif I Ekinci
Cardiovascular (CV) and kidney disease are common and significant complications in people with type 2 diabetes (T2DM). CV disease is the leading cause of death, morbidly and hospitalisations for people with T2DM. Furthermore, diabetic kidney disease is a major risk factor for CV disease and is the main reason why patients need renal replacement therapy. In this perspective, we highlight the results of the recent landmark EMPA-REG OUTCOME trial which has shown that empagliflozin, a member of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor class of glucose lowering medications, reduces death from CV causes, hospitalisation for heart failure and progression to end stage kidney disease in patients with T2DM and established CV disease...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27835680/benefits-and-harms-of-sodium-glucose-co-transporter-2-inhibitors-in-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#10
Heidi Storgaard, Lise L Gluud, Cathy Bennett, Magnus F Grøndahl, Mikkel B Christensen, Filip K Knop, Tina Vilsbøll
OBJECTIVE: Sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are a novel drug class for the treatment of diabetes. We aimed at describing the maximal benefits and risks associated with SGLT2-i for patients with type 2 diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND STUDY SELECTION: We included double-blinded, randomised controlled trials (RCTs) evaluating SGLT2-i administered in the highest approved therapeutic doses (canagliflozin 300 mg/day, dapagliflozin 10 mg/day, and empagliflozin 25 mg/day) for ≥12 weeks...
2016: PloS One
https://www.readbyqxmd.com/read/27819144/effects-of-sodium-glucose-co-transporter-2-inhibitors-on-metabolism-unanswered-questions-and-controversies
#11
Vasilios Tsimihodimos, Theodosios D Filippatos, Moses S Elisaf
Sodium-glucose co-transporter 2 (SGLT2) inhibitors inhibit glucose re-absorption in the proximal renal tubules. These drugs also affect many anthropometric and metabolic parameters with various mechanisms of action. Areas covered: We present the available evidence regarding these effects. SGLT2 inhibitors can decrease body weight mainly due to a reduction of total fat mass. SGLT2 inhibitors can decrease blood pressure levels and serum uric acid levels and may also reduce the degree of diabetes-related albuminuria...
November 17, 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27717592/euglycemic-diabetic-ketoacidosis-with-elevated-acetone-in-a-patient-taking-a-sodium-glucose-cotransporter-2-sglt2-inhibitor
#12
Tory J Andrews, Robert D Cox, Christina Parker, James Kolb
BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitor medications are a class of antihyperglycemic agents that increase urinary glucose excretion by interfering with the reabsorption of glucose in the proximal renal tubules. In May of 2015, the U.S. Food and Drug Administration released a warning concerning a potential increased risk of ketoacidosis and ketosis in patients taking these medications. CASE REPORT: We present a case of a 57-year-old woman with type 2 diabetes mellitus taking a combination of canagliflozin and metformin who presented with progressive altered mental status over the previous 2 days...
February 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27677576/euglycaemic-ketoacidosis-in-a-postoperative-whipple-patient-using-canaglifozin
#13
Trevor Wood, Allison J Pang, Julie Hallet, Paul Greig
SGLT2 inhibitors are a new class of oral antihyperglycaemic agents that have garnered much attention for their attractive efficacy profile in glycaemic control along with the added benefit of weight loss. There has been increasing concern for the risk of euglycaemic (serum glucose 4-8 mmol/L) ketoacidosis with these agents. In the setting of a postoperative patient, the use of these drugs may exacerbate the normal physiological stresses of the body and increase the risk of developing euglycaemic ketoacidosis (euKDA)...
September 27, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27598833/sodium-glucose-co-transporter-2-inhibitors-in-addition-to-insulin-therapy-for-management-of-type-2-diabetes-mellitus-a-meta-analysis-of-randomized-controlled-trials
#14
Huilin Tang, Wei Cui, Dandan Li, Tiansheng Wang, Jingjing Zhang, Suodi Zhai, Yiqing Song
Given inconsistent trial results of sodium-glucose cotransporter 2 (SGLT2) inhibitors in addition to insulin therapy for treating type 2 diabetes mellitus (T2DM), a meta-analysis was performed to evaluate the efficacy and safety of this combination for T2DM by searching available randomized trials from PubMed, Embase, CENTRAL and ClinicalTrials.gov. Our meta-analysis included seven eligible placebo-controlled trials involving 4235 patients. Compared with placebo, SGLT2 inhibitor treatment was significantly associated with a mean reduction in HbA1c of -0...
January 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27592508/sglt2-inhibitors-in-the-pipeline-for-the-treatment-of-diabetes-mellitus-in-japan
#15
Hiroyuki Ito, Masahiro Shinozaki, Shinya Nishio, Mariko Abe
INTRODUCTION: Sodium glucose cotransporter 2 (SGLT2) inhibitors have been available for the treatment of type 2 diabetes (T2DM) in Japan since April 2014. The prescription rate in Japan is low in comparison to Western countries. We summarize the results obtained from the phase 3 clinical trials and clinical studies involving Japanese T2DM patients. We also discuss the current situation and the future prospects of SGLT2 inhibitors in Japan. AREAS COVERED: Unexpected adverse events, such as cerebral infarction and diabetic ketoacidosis have been reported from clinics shortly after the initiation of SGLT2 inhibitor treatment...
October 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27541294/sglt2-inhibitors-benefit-risk-balance
#16
REVIEW
André J Scheen
Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) reduce hyperglycemia by increasing urinary glucose excretion. They have been evaluated in patients with type 2 diabetes treated with diet/exercise, metformin, dual oral therapy or insulin. Three agents are available in Europe and the USA (canagliflozin, dapagliflozin, empagliflozin) and others are commercialized in Japan or in clinical development. SGLT2 inhibitors reduce glycated hemoglobin, with a minimal risk of hypoglycemia. They exert favorable effects beyond glucose control with consistent body weight, blood pressure, and serum uric acid reductions...
October 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27510353/lessons-from-the-bedside-ketoacidosis-and-sglt2-inhibitors
#17
Yvonne Y Chow, Roisin Worsley, Duncan J Topliss
No abstract text is available yet for this article.
August 15, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27486328/an-overview-of-the-effect-of-sodium-glucose-cotransporter-2-inhibitor-monotherapy-on-glycemic-and-other-clinical-laboratory-parameters-in-type-2-diabetes-patients
#18
Yaowen Wang, Xueting Hu, Xueying Liu, Zengqi Wang
OBJECTIVES: We aimed to determine the effect of sodium glucose cotransporter 2 (SGLT2) inhibitor monotherapy on glycemic and other clinical laboratory parameters versus other antidiabetic medications or placebo therapy in patients with type 2 diabetes mellitus. In addition, we aimed to investigate the risk of diabetic ketoacidosis associated with SGLT2 inhibitor therapy and evaluate its weight-sparing ability. DESIGN: Meta-analysis. MATERIALS AND METHODS: PubMed and MEDLINE were searched to identify eligible studies up to December 2015...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27440828/positioning-sglt2-inhibitors-incretin-based-therapies-in-the-treatment-algorithm
#19
REVIEW
John P H Wilding, Surya Panicker Rajeev, Ralph A DeFronzo
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recent addition to the therapeutic options available for the treatment of type 2 diabetes and became available after the introduction of incretin-based therapies, dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs). These agents have potential advantages with regard to their weight loss-promoting effect, low risk of hypoglycemia, reduction in blood pressure, and reduction in cardiovascular events in high-risk patients (with empagliflozin)...
August 2016: Diabetes Care
https://www.readbyqxmd.com/read/27375734/euglycemic-diabetic-ketoacidosis-in-a-27-year-old-female-patient-with-type-1-diabetes-treated-with-sodium-glucose-cotransporter-2-sglt2-inhibitor-canagliflozin
#20
Nimrah Bader, Lubna Mirza
We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin...
May 2016: Pakistan Journal of Medical Sciences Quarterly
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