Empagliflozin on top of metformin treatment improves arterial function in patients with type 1 diabetes mellitus

Lunder, Mojca; Janić, Miodrag; Japelj, M.; Juretič, Andrej; Janež, Andrej; Šabovič, Mišo

doi:10.1186/s12933-018-0797-6

Cited by 82 publications

(80 citation statements)

References 28 publications

(36 reference statements)

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“…Researchers concluded that SGLT‐2 inhibitor‐mediated reduction in blood pressure and body weight, improvement of glycemia, and suppression of oxidative stress might contribute to the observed decrease in PWV . In a more recent RCT enrolling 40 patients with T1DM, it was shown that administration of empagliflozin or empagliflozin/metformin combination for 12 weeks decreased arterial stiffness by 14.3% and 15.8% ( P < .01), respectively, compared to placebo, which did not induce any change . An interesting point is that both empagliflozin and empagliflozin/metformin combination had the same effect on endothelial function, as assessed by flow‐mediated dilation (FMD) and reactive hyperemia index (RHI), leading to the conclusion that the observed improvement in arterial stiffness with empagliflozin might be independent of its effect on endothelial dysfunction …”

Section: Sglt‐2 Inhibitors and Arterial Stiffness: A New Place Undermentioning

confidence: 99%

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Patoulias

Papadopoulos

Stavropoulos

et al. 2020

J of Clinical Hypertension

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Type 2 diabetes mellitus (T2DM) constitutes a global pandemic, representing the 7th cause of death worldwide. Morbidity and mortality of patients with T2DM are gradually increasing, while prevalence of cardiovascular disease (CVD) among these patients is almost 14% greater compared to the general population. Arterial stiffness is nowadays a valuable biomarker of CVD and a promising treatment target in specific patient groups, including those suffering from T2DM. Despite that fact, design of the available studies cannot prove causal relationship. Recently, a new antidiabetic drug class, namely sodium-glucose co-transporter-2 (SGLT-2) inhibitors, has attracted scientific interest, due to their multiple, beneficial, pleiotropic effects, especially those focused on CVD. There is limited relevant literature concerning the effects of SGLT-2 inhibitors on arterial stiffness, while retrieved results might be considered as conflicting. The aim of the present review article is to summarize acquired knowledge regarding the prognostic role of arterial stiffness in T2DM, along with the presentation of retrieved data on the potential role of SGLT-2 inhibitors. | 563 PATOULIAS eT AL.

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Section: Sglt‐2 Inhibitors and Arterial Stiffness: A New Place Undermentioning

confidence: 99%

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Patoulias

Papadopoulos

Stavropoulos

et al. 2020

J of Clinical Hypertension

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show abstract

“…Despite the positive results from clinical trials and evidence‐based guideline recommendations for the use of SGLT2 inhibitors, the precise mechanisms underlying the cardiorenal protective effects of these agents remain to be fully elucidated. A number of beneficial cardiovascular effects of SGLT2 inhibitors have been investigated, including reductions in blood pressure (BP), 6,7 attenuation of the salt sensitivity of BP, 8 improvements in arterial stiffness, 9 and sympatholytic effects 8 . We recently demonstrated that SGLT2 inhibitors significantly reduced out‐of‐office BP determined using ambulatory or home BP monitoring compared with placebo or control in patients with type 2 diabetes and uncontrolled nocturnal hypertension (a salt‐sensitive hypertension phenotype) 10,11 …”

Section: Introductionmentioning

confidence: 99%

Effects of luseogliflozin on arterial properties in patients with type 2 diabetes mellitus: The multicenter, exploratory LUSCAR study

Kario

Okada

Murata³

et al. 2020

J of Clinical Hypertension

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“…The trial was done on 40 patients for 12 weeks. The results showed a marked improvement in all assessments [19].…”

Section: Effect Of Sglt2 Inhibitors On Arterial Efficacymentioning

confidence: 84%

Use of Sodium-Glucose Co-Transporter-2 Inhibitors in Type 1 Diabetics: Are the Benefits Worth the Risks?

Fatima¹,

Sedrakyan²,

Awan³

et al. 2020

Cureus

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The mainstay of treatment for type 1 diabetes is insulin. The use of insulin for tight glycemic control is the key to preventing micro-and macrovascular complications, but it can also lead to hypoglycemic episodes. Therefore, there is a need for the introduction of a drug that can maintain glucose levels within a safe range without increasing the risk of hypoglycemia. For this reason, SGLT2 (sodium-glucose co-transporter-2) inhibitors has been a hot topic in the last couple of years. They have been proved very efficient in treating type 2 diabetes. Many trials on the safety and efficacy of SGLT2 inhibitors have been done on type 1 diabetics. Some other studies have also been done that prove their benefits in increasing arterial efficacy and reducing GFR (glomerular filtration rate). This review article discusses the benefits and risks. The literature search was performed using PubMed, and after applying the inclusion and exclusion criteria, 16 published papers were found. All relevant articles on the topic have been included. Our review has shown that the benefits of SGLT2 inhibitors outweigh their risks. Their benefits include good glycemic control, HBA1c (glycated haemoglobin) reduction, weight loss, and blood pressure improvement. Furthermore, improvement in GFR and arterial efficacy is also significant. Side effects such as UTI (urinary tract infection) and genital infection have been observed, but their incidence is low. However, DKA (diabetic ketoacidosis) and hypoglycemia are severe side effects that should be highlighted. Hypoglycemia can be prevented by strictly monitoring blood sugar levels. The patient must be educated and counseled about DKA and its symptoms. This will ensure the safety of the patient as euglycemic DKA can prove fatal if not diagnosed earlier. So, SGLT2 inhibitors can be used as an effective drug to control blood sugar levels in type 1 diabetes, especially in patients with a BMI higher than 30. It will not only achieve the treatment goals but can also decrease the morbidity and mortality of the patients. However, more studies need to be done to fully understand DKA caused by SGLT2 inhibitors.

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Empagliflozin on top of metformin treatment improves arterial function in patients with type 1 diabetes mellitus

Cited by 82 publications

References 28 publications

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Effects of luseogliflozin on arterial properties in patients with type 2 diabetes mellitus: The multicenter, exploratory LUSCAR study

Use of Sodium-Glucose Co-Transporter-2 Inhibitors in Type 1 Diabetics: Are the Benefits Worth the Risks?

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