The employment of sodium-glucose cotransporter 2 (SGLT-2) inhibitors in the treatment of diabetes mellitus and diabetic kidney disease (DKD) becomes a hot topic in recent years. Compared with traditional glucose-lowering drugs, SGLT-2 inhibitors present distinctive advantages in renal and cardiovascular protection. The mechanisms for renal protection include attenuating glomerular hyperfiltration, lowering serum uric acid, alleviating tubular lesions and regulating intrarenal renin-angiotensin-aldosterone system (RAAS) dysfunction. In addition, the lowering blood pressure, blunting blood glucose fluctuation, increasing insulin sensitivity, optimizing energy metabolism and body fat distribution account for the cardiovascular protective effects of SGLT-2 inhibitors. However, their potential adverse reactions and safety concerns should be carefully addressed in clinical usage.
Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; drug therapy ; Humans ; Hypoglycemic Agents ; pharmacology ; Sodium-Glucose Transporter 2 ; Sodium-Glucose Transporter 2 Inhibitors ; pharmacology ; Uric Acid

We aimed to identify the clinical variables associated with a better glucose-lowering response to the sodium glucose cotransporter 2 inhibitor ipragliflozin in people with type 2 diabetes mellitus (T2DM). We especially focused on urinary glucose excretion (UGE). This was a single-arm multicenter prospective study. A total of 92 people with T2DM aged 20 to 70 years with glycosylated hemoglobin (HbA1c) levels ≥7.0% and ≤9.5% were enrolled. Ipragliflozin (50 mg) was added to the background therapy for these people for 12 weeks. After 3 months treatment with ipragliflozin, the mean HbA1c levels were decreased from 7.6% to 6.9% and 62.0% of the people reached the HbA1c target of less than 7.0% (P<0.001). In addition, body weight, blood pressure, and lipid parameters were improved after ipragliflozin treatment (all P<0.001). The baseline HbA1c (r=0.66, P<0.001) and morning spot urine glucose to creatinine ratio (r=−0.30, P=0.001) were independently associated with the HbA1c reduction. Ipragliflozin treatment for 12 weeks improves glycemic control and other metabolic parameters. A higher HbA1c and lower UGE at baseline predicts a better glucose-lowering efficacy of ipragliflozin.
Blood Pressure ; Body Weight ; Creatinine ; Diabetes Mellitus, Type 2 ; Glucose ; Glycosuria ; Hemoglobin A, Glycosylated ; Prospective Studies ; Sodium ; Sodium-Glucose Transporter 2

Humans ; Diabetes Mellitus, Type 2/drug therapy* ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use* ; Arrhythmias, Cardiac/etiology* ; Glucose ; Sodium

Humans ; Diabetes Mellitus, Type 2/drug therapy* ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use* ; Arrhythmias, Cardiac/etiology* ; Glucose ; Sodium

No abstract available.
Glucosides ; Glycated Hemoglobin A ; Sodium-Glucose Transporter 2 Inhibitors ; Diabetes Mellitus, Type 2 ; Glomerular Filtration Rate

No abstract available.
Glucosides ; Glycated Hemoglobin A ; Sodium-Glucose Transporter 2 Inhibitors ; Diabetes Mellitus, Type 2 ; Glomerular Filtration Rate

Introduction: Sodium glucose transporter 2 (SGLT2) inhibitors are a new class of anti-diabetic agents that not only lower down blood sugar but can potentially cause weight loss and decrease in blood pressure. The aim of this meta-analysis is to evaluate the magnitude of changes in blood pressure and safety parameters with the use of SGLT2 inhibitors among adult patients with type 2 diabetes mellitus (DM). Methods: Randomized controlled trials (RCTs) were retrieved from electronic databases. We used the method recommend by the Cochrane Collaboration to perform a meta-analysis of RCTs of SGLT2 inhibitor for type 2 DM. Results: Of 137 studies retrieved in the literature search, 28 were eligible for inclusion. A total of 23,728 patients with average age of 50-63 years old, when SGLT2 inhibitor were compared with placebo or active comparators there were statistically significant reduction in systolic (MD: -4.01, 95% CI -4.03 to -3.99) and diastolic blood pressure (MD: -1.48, 95% CI -1.49 to -1.46). There were no significant differences in the incidence of hypoglycemia (RR: 0.94, 95% CI 0.90 to 0.99, P<0.00001) between SGLT2 inhibitors and control groups. The incidence of urinary tract infections was similar between the SGLT2 inhibitors and the control groups (RR: 1.12, 95% CI 1.01 to 1.25, P=1.00). There was statistically greater incidence of orthostatic hypotension among patients given SGLT2 inhibitors than the control group (RR: 1.41, 95% CI 1.14 to 1.75, P=0.99). Conclusion Treatment with SGLT2 inhibitor provided statistically significant reductions in systolic and diastolic blood pressure in patients with type 2 DM compared with placebo or other anti-diabetic agents.
Blood Pressure ; Sodium-Glucose Transporter 2 Inhibitors ; Diabetes Mellitus, Type 2

Diabetes Mellitus, Type 2 ; Humans ; Myocardial Infarction/drug therapy* ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use*

Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Humans ; Sodium-Glucose Transporter 2 Inhibitors

Administration, Oral ; Glucose Transporter Type 2 ; metabolism ; Humans ; Intestinal Absorption ; physiology ; Organic Anion Transporters ; metabolism ; Peptide Transporter 1 ; Pharmacokinetics ; Sodium-Glucose Transporter 1 ; metabolism ; Symporters ; metabolism