Lipid Profile Changes Associated with SGLT-2 Inhibitors and GLP-1 Agonists in Diabetes and Metabolic Syndrome

Premji, Resmi; Nylen, Eric; Naser, Nejat; Gandhi, Sanyam; Burman, Kenneth D.; Sen, Sabyasachi

doi:10.1089/met.2022.0004

Cited by 7 publications

(5 citation statements)

References 67 publications

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“…Collectively, pioglitazone appears to have favorable effects on certain lipid parameters, and the reductions in these lipids seem to be linked to reductions in insulin resistance. c) Effects on lipids with SGLT-2 inhibitors are controversial [23]. In this study, with canagliflozin, insignificant down-regulation of TG and significant up-regulation of HDL-C were observed (Table 4C).…”

Section: Link Between Changes In Insulin Resistance and Diabetic Para...mentioning

confidence: 53%

Diverse Strategies for Modulating Insulin Resistance: Causal or Consequential Inference on Metabolic Parameters in Treatment-Naïve Subjects with Type 2 Diabetes

Kutoh,

Kuto,

Okada

et al. 2024

Preprint

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The objective of this study is to investigate how different therapies modulating insulin resistance, either causally or consequently, affect metabolic parameters in treatment-naive subjects with T2DM. A total of 212 subjects were assigned to receive either a tight Japanese diet (n=65), pioglitazone at doses ranging from 15-30 mg/day (n=70), or canagliflozin at doses ranging from 50-100 mg/day (n=77) for a duration of three months. Correlations and changes (Δ) in metabolic parameters relative to insulin resistance were investigated. Across these distinct therapeutic interventions, ΔHOMA-R exhibited significant correlations with ΔFBG and ΔHOMA-B, while demonstrating a negative correlation with baseline HOMA-R. However, other parameters such as ΔHbA1c, ΔBMI, ΔTC, ΔTG, Δnon-HDL-C, or ΔUA displayed varying patterns depending on the treatment regimens. Participants were stratified into two groups based on the median value of ΔHOMA-R: the lower half (X) and upper half (Y). Group X consistently demonstrated more pronounced reductions in FBG compared to Group Y across all treatments, while other parameters including HbA1c, HOMA-B, TC, TG, HDL-C, non-HDL-C, TG/HDL-C ratio, or UA exhibited distinct regulatory responses depending on the treatment administered These findings suggest that 1) regression to the mean is observed in the changes of insulin resistance across these therapies. 2) modulation of insulin resistance with these therapies, either causally or consequentially, results in differential effects on glycemic parameters, beta-cell function, specific lipids, body weight or UA.

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Section: Link Between Changes In Insulin Resistance and Diabetic Para...mentioning

confidence: 53%

Diverse Strategies for Modulating Insulin Resistance: Causal or Consequential Inference on Metabolic Parameters in Treatment-Naïve Subjects with Type 2 Diabetes

Kutoh,

Kuto,

Okada

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Collectively, pioglitazone appears to have favorable effects on certain lipid parameters, and the reductions in these lipids seem to be linked to reductions in insulin resistance. Effects on lipids with SGLT-2 inhibitors are controversial [ 23 ]. In this study, with canagliflozin, the insignificant down-regulation of TG and significant up-regulation of HDL-C were observed ( Table 4 C).…”

Section: Discussionmentioning

confidence: 99%

“…Effects on lipids with SGLT-2 inhibitors are controversial [ 23 ]. In this study, with canagliflozin, the insignificant down-regulation of TG and significant up-regulation of HDL-C were observed ( Table 4 C).…”

Section: Discussionmentioning

confidence: 99%

Diverse Strategies for Modulating Insulin Resistance: Causal or Consequential Inference on Metabolic Parameters in Treatment-Naïve Subjects with Type 2 Diabetes

Kutoh,

Kuto,

Okada

et al. 2024

Medicina

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Bacground and Objectives: The objective of this study is to investigate how different therapies modulating insulin resistance, either causally or consequently, affect metabolic parameters in treatment-naïve subjects with T2DM. Subjects and Methods: A total of 212 subjects were assigned to receive either a tight Japanese diet (n = 65), pioglitazone at doses ranging from 15–30 mg/day (n = 70), or canagliflozin at doses ranging from 50–100 mg/day (n = 77) for a duration of three months. Correlations and changes (Δ) in metabolic parameters relative to insulin resistance were investigated. Results: Across these distinct therapeutic interventions, ΔHOMA-R exhibited significant correlations with ΔFBG and ΔHOMA-B, while demonstrating a negative correlation with baseline HOMA-R. However, other parameters such as ΔHbA1c, ΔBMI, ΔTC, ΔTG, Δnon-HDL-C, or ΔUA displayed varying patterns depending on the treatment regimens. Participants were stratified into two groups based on the median value of ΔHOMA-R: the lower half (X) and upper half (Y). Group X consistently demonstrated more pronounced reductions in FBG compared to Group Y across all treatments, while other parameters including HbA1c, HOMA-B, TC, TG, HDL-C, non-HDL-C, TG/HDL-C ratio, or UA exhibited distinct regulatory responses depending on the treatment administered. Conclusions: These findings suggest that (1) regression to the mean is observed in the changes in insulin resistance across these therapies and (2) the modulation of insulin resistance with these therapies, either causally or consequentially, results in differential effects on glycemic parameters, beta-cell function, specific lipids, body weight, or UA.

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“…These molecules have radically changed the T2D management, as beyond increasing insulin secretion, they retain many other beneficial effects for T2D, including reductions in appetite which may favor body weight loss, lowering glucagon secretion and delaying gastric emptying, reduce inflammation, and, not least, improve cardiovascular health ( Table 3 ). Moreover, GLP-1 displayed the capacity to reduce blood pressure and improve dyslipidemia, particularly by reducing triglycerides levels in T2D patients [ 10 , 11 , 12 ].…”

Section: Glp-1 Receptor Agonistsmentioning

confidence: 99%

New Molecules in Type 2 Diabetes: Advancements, Challenges and Future Directions

Chatzianagnostou,

Gaggini,

Suman Florentin

et al. 2024

IJMS

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Although good glycemic control in patients with type 2 diabetes (T2D) can prevent cardiovascular complications, many diabetic patients still have poor optimal control. A new class of antidiabetic drugs (e.g., glucagon-like peptide-1-GLP-1 receptor agonists, sodium-glucose co-transporters-SGLT2 inhibitors), in addition to the low hypoglycemic effect, exert multiple beneficial effects at a metabolic and cardiovascular level, through mechanisms other than antihyperglycemic agents. This review aims to discuss the effects of these new antidiabetic drugs, highlighting cardiovascular and metabolic benefits, through the description of their action mechanisms as well as available data by preclinical and clinical studies. Moreover, new innovative tools in the T2D field will be described which may help to advance towards a better targeted T2D personalized care in future.

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Lipid Profile Changes Associated with SGLT-2 Inhibitors and GLP-1 Agonists in Diabetes and Metabolic Syndrome

Cited by 7 publications

References 67 publications

Diverse Strategies for Modulating Insulin Resistance: Causal or Consequential Inference on Metabolic Parameters in Treatment-Naïve Subjects with Type 2 Diabetes

Diverse Strategies for Modulating Insulin Resistance: Causal or Consequential Inference on Metabolic Parameters in Treatment-Naïve Subjects with Type 2 Diabetes

Diverse Strategies for Modulating Insulin Resistance: Causal or Consequential Inference on Metabolic Parameters in Treatment-Naïve Subjects with Type 2 Diabetes

New Molecules in Type 2 Diabetes: Advancements, Challenges and Future Directions

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