Sodium Glucose Co-transporter 2 Inhibitors and Heart Failure

Sodium-glucose co-transporter 2 (SGLT2) receptors are primarily located in the proximal convoluted tubule of the nephron. These receptors are responsible for almost 90-95% of tubular reabsorption of the glucose in the nephron. In patients with diabetes mellitus (DM), due to upregulation of SGLT2 receptors, glucose reabsorption is further increased. The Food and Drug Administration (FDA) approved SGLT2 inhibitors, such as canagliflozin, empagliflozin, dapagliflozin, and ertugliflozin, for the treatment of type 2 diabetes.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research

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Abstract OBJECTIVE: This umbrella review provides an overview of the consistency and gaps in the evidence base on eggs and cardiometabolic health. DESIGN: PubMed, Web of Science, Cochrane Library, the Nutrition Evidence Systematic Review and Agency for Healthcare Research and Quality databases were screened for evidence-based reviews in English that assessed human studies on egg consumption and cardiometabolic outcomes. RESULTS: Seven systematic reviews and fifteen meta-analyses were identified, with eighteen of these published since 2015. Overall, the systematic reviews were of low quality, while meta-a...
Source: Public Health Nutrition - Category: International Medicine & Public Health Authors: Tags: Public Health Nutr Source Type: research
AbstractIntroductionThe results of recently completed cardiovascular outcomes trials in patients with type 2 diabetes mellitus (T2DM) suggest that sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide (GLP) 1 receptor agonists have enhanced cardioprotective properties in patients with established cardiovascular disease (eCVD), but to a lesser degree in those without eCVD. SGLT2 inhibitors appear to be particularly beneficial in patients with heart failure. As recent data for the UK are lacking, we undertook to identify the percentage of T2DM patients with eCVD and heart failure in the UK.MethodsThis w...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
Authors: Papakitsou I, Vougiouklakis G, Elisaf MS, Filippatos TD Abstract Dapagliflozin belongs in the family of sodium-glucose cotransporter 2 (SGLT2) inhibitors and acts by reducing glucose reabsorption in the proximal tubule. The aim of this review is to present the differential pharmacology and clinical utility of dapagliflozin. Dapagliflozin is orally administered, has a long half-life of 12.9 hours and (similar to empagliflozin) is a much weaker SGLT1 inhibitor compared with canagliflozin. Dapagliflozin significantly decreases glycated hemoglobin and fasting glucose levels in patients with type 2 diabetes mel...
Source: Clinical Pharmacology: Advances and Applications - Category: Allergy & Immunology Tags: Clin Pharmacol Source Type: research
THURSDAY, Oct. 3, 2019 -- A novel machine learning-derived risk score can predict the risk for heart failure among outpatients with type 2 diabetes mellitus (T2DM), according to a study published online Sept. 13 in Diabetes Care to coincide with the...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Authors: Selthofer-Relatić K, Kibel A, Delić-Brkljačić D, Bošnjak I Abstract Obesity is a risk factor for cardiometabolic and vascular diseases like arterial hypertension, diabetes mellitus type 2, dyslipidaemia, and atherosclerosis. A special role in obesity-related syndromes is played by cardiac visceral obesity, which includes epicardial adipose tissue and intramyocardial fat, leading to cardiac steatosis; hypertensive heart disease; atherosclerosis of epicardial coronary artery disease; and ischemic cardiomyopathy, cardiac microcirculatory dysfunction, diabetic cardiomyopathy, and atrial fibrillation...
Source: Journal of Obesity - Category: Eating Disorders & Weight Management Tags: J Obes Source Type: research
Authors: PMID: 31525098 [PubMed - in process]
Source: Circulation - Category: Cardiology Tags: Circulation Source Type: research
AbstractPurpose of ReviewTo review the clinical trial data and underlying mechanistic principles in support of the robust cardiovascular (CV) benefits, in particular, heart failure (HF) outcomes association with sodium-glucose co-transporter-2 (SGLT2) inhibitors.Recent FindingsSeveral large CV outcome trials in patients with type 2 diabetes mellitus (T2DM) and with either established atherosclerotic CV disease (ASCVD) or at high risk for ASCVD reveal that SGLT2 inhibitors cause reductions in CV and HF endpoints. The reduction in ASCVD appears to be confined to those with established ASCVD on the order of ≈ 14%...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
We propose a unifying perspective of heart failure in patients with type 2 diabetes mellitus. The reasoning is as follows: cellular responses to fuel overload include dysregulated insulin signaling, impaired mitochondrial respiration, reactive oxygen species formation and the accumulation of certain metabolites, collectively termed glucolipotoxicity. As a consequence, cardiac function is impaired with intracellular calcium cycling and diastolic dysfunction as an early manifestation. In this setting, increasing glucose uptake by insulin or insulin sensitizing agents only worsens the disrupted fuel homeostasis of the heart.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Review Source Type: research
Conclusion: Meta-analyses of all glucose-lowering RCTs involving patients with diabetes provide precise estimates of benefits for CHD and major cardiovascular events after consideration of the resulting ongoing BP difference. No benefit or harm on mortality, heart failure and stroke were noticed, while discontinuations related to adverse events because of treatment were increased following glucose-lowering. The extent of glucose-lowering is proportionally related to changes of CHD and stroke composite, and treatment-related discontinuations.
Source: Journal of Hypertension - Category: Cardiology Tags: REVIEWS AND META-ANALYSES Source Type: research
PMID: 31474116 [PubMed - as supplied by publisher]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
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