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A new approach to the treatment of the Type 2 diabetes mellitus (T2DM) based on drug-induced glycosuria and reduction in renal threshold of glucose, and drugs with a similar mechanism of action belong to an innovative class of antidiabetic drugs: inhibitors of 2nd type sodium-glucose cotransporter (GLT-2). In addition to improving glycemic control SGCT-2 inhibitors promote moderate weight loss and blood pressure (BP), increased sensitivity of tissues to insulin and improve β-cell function. Dapagliflozin an oral SGCT-2 inhibitor, which is due to the insulin independent mechanism of action is characterized by the minimal risk of hypoglycemia compared to traditional antidiabetic drugs, such as sulfonylurea and insulin. For this reason, the drug has the unique ability to combine with other oral hypoglycemic agents (OHGA). In addition, due to its natriuretic effect and ability to reduce body weight and blood pressure dapagliflozin is the drug of choice in patients with T2DM and cardiovascular diseases of atherosclerotic genesis. A combination of advantages, including a favorable safety profile of dapagliflozin allows extensive use of this drug for the initiation and intensification of T2DM treatment.
The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.
A total of 51 men at a mean age of 55±5.2 years with coronary heart disease were available for examination. Twenty of them presented with confirmed age-related androgen deficiency while the remaining 31 had the testosterone level within the normal reference values. The study included characteristic of lipid and carbohydrate metabolism, diagnosis of obesity and its type, estimation of the depression level, echocardiographic imaging, 24-hour ECG monitoring, and myocardial perfusion scintigraphy. The patients with androgen deficiency were shown to more frequently suffer abdominal obesity and high-level depression than those with the normal testosterone level. Moreover, patients of the former group usually had atypical anginal syndrome. The deficit of androgens was not infrequently associated with a rise in the number of ventricular extrasystoles. The correlation analysis demonstrated a significant negative relationship between the total testosterone level, blood glucose and triglyceride levels, the duration of ST segment ischemic depression.
At the online meeting held on September 3, 2020, the results of the international multicenter trial EMPEROR-REDUCED were considered. Number of proposals and recommendations for the further study of cardiovascular and renal effects of empagliflozin and its practical use in heart failure patients were agreed.
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