For those who take SGLT2 inhibitors & Exercise, found this interesting

Conclusion: The efficacy of combining two beneficial antidiabetes interventions, regular endurance exercise and SGLT2 inhibition, was not supported. SGLT2 inhibition blunted endurance exercise training-induced improvements in insulin sensitivity, independent of effects on aerobic fitness or body composition.

Full Paper Here: Influence of Sodium Glucose Cotransporter 2 Inhibition on Physiological Adaptation to Endurance Exercise Training

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Thanks for sharing, I wasn’t aware of this. I wonder how much of these effects are meditated by the diet or timing of ingesting food.

For e.g. Do SGLT-2 inhibitors still effect exercising patients negatively if they’re exercising fasted or if they’re on a ketogenic diet?

Not sure, I wonder if it’s because of the prevention of being able to reabsorb glucose for energy that it causes these effects.
Makes me wonder if taking SGLT2 inhibitors a couple hours after exercise is better.

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Makes sense. I’ve heard of anecdotes about blood glucose levels rising (endogenous production) when people exercise, but with sglt-2 now some of this gets excreted instead of being used up?

SGLT2 inhibitors selectively block glucose reabsorption in the proximal convoluted tubule which results in a decreased renal threshold for glucose excretion. Renal excretion of glucose then reduces levels of circulating glucose

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OK - so I initially thought that this might be a paper that would suggest a problem similar to the issue of metformin blunting the benefits of exercise (which led me to halt my year-long personal experiment with rapamycin), but after reviewing the above paper a little more I don’t think thats the case. All the paper is saying is that in terms of insulin sensitivity - there were no additional benefits seen when a person was on both SGLT2 inhibitors (e.g. canagliflozin or empagliflozin) and doing endurance exercise.

I’m fine with that - my insulin sensitivity is fine - I’m not taking the SGLT2 inhibitor for that benefit, I’m just taking it (first canagliflozin, then empagliflozin) for the benefit of blunting of the glucose spikes from meals - and to get the lifespan benefit shown in the National Institute of Aging ITP studies.

You still, I believe, get all the other benefits of exercise (and this study was just looking at endurance exercise, not the many other types of exercise - HIIT, resistance training, etc.

Moreover, there are other studies - when you look at SGLT2 inhibitors and exercise - that suggest other benefits:

The combination of exercise training and sodium-glucose cotransporter-2 inhibition improves glucose tolerance and exercise capacity in a rodent model of type 2 diabetes

Highlights

  • SGLT2i combined with exercise lowered body weight and adiposity.
  • Exercise and SGLT2i independently improved indices of glycemic control.
  • Combined SGLT2i and exercise had additive benefits during a glucose challenge.
  • Combined SGLT2i and exercise increased energy expenditure.
  • Submaximal exercise capacity was further improved with SGLT2i and exercise.

Purpose: Exercise is recommended in addition to pharmacotherapies for the management of type 2 diabetes, but metformin and exercise training may have non-additive or even inhibitory effects on exercise-induced improvements in glycemic control and exercise capacity. The objectives of this report were to determine if co-treatment with a sodium-glucose cotransporter-2 inhibitor and exercise could (1) further improve glycemic control when compared to either monotherapy and (2) not worsen exercise capacity when compared to exercise alone.

Conclusions: If these findings with the combination of SGLT2i and exercise translate to humans, they will have important clinical health implications.

Full Paper Here: The combination of exercise training and sodium-glucose cotransporter-2 inhibition improves glucose tolerance and exercise capacity in a rodent model of type 2 diabetes


SGLT2 inhibition modulates NLRP3 inflammasome activity via ketones and insulin in diabetes with cardiovascular disease

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular events in humans with type 2 diabetes (T2D); however, the underlying mechanism remains unclear.

Activation of the NLR family, pyrin domain-containing 3 (NLRP3) inflammasome and subsequent interleukin (IL)-1β release induces atherosclerosis and heart failure. Here we show the effect of SGLT2 inhibitor empagliflozin on NLRP3 inflammasome activity.

In conclusion, SGLT2 inhibitor attenuates NLRP3 inflammasome activation, which might help to explain its cardioprotective effects.

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Nice find! Yeah wasn’t sure of how much research has been done with SGLT2i’s and exercise and I just stumbled upon the one I shared.

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Yes - there is really very little research on this issue (SGLT2i and exercise) so far. I’m sure more will come out over the next few years as SGLT2 inhibitors are becoming very popular, it seems.

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There are numerous articles, too many to count, citing evidence of how SGLT2 Inhibitors are of benefit to those with cardiovascular disease, with and without diabetes. My question is, would I get the rx from the PCP, cardiologist, or the antiaging doctor who prescribes my metformin and rapa? Given my experience with the typical in the box doctor, I can see my request being futile. Has anyone obtained SGLT2 inhibitors without a prescription from one of the sources ?

It’s easy to get sglt2 inhibitors from most of the listed Indian pharmacies, no prescription necessary. Buy Rapamycin Online - List of Reliable Pharmacies

Thanks, I will definitely be looking to buy rapa powder to make the topical, as well as rapa tablets.

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