Recent Research on SGLT-2 Inhibitors, Canagliflozin, Empagliflozin, etc. - As cardio-renal protective agents

SGLT2 inhibitors as cardio-renal protective agents

Good news continues to come out on SGLT2 inhibitors as the research below highlights. This study was funded by the drug companies, so I’m more skeptical of its accuracy, but interesting to keep in mind:

another study:

and another:

Use of SGLT2 inhibitors was linked with a 6.1% lower risk of cardiovascular disease over 5 years (with up to an 11.1% lower risk in individuals with signs of kidney disease) and with a 5.3% lower risk of kidney failure (with up to a 7.6% lower risk in those with signs of kidney disease).

and as we’ve mentioned before, SGLT2 inhibitors can, for many people, help with weight loss during the first month of initiation. It doesn’t seem to continue after the initial month or so, but during that first month, with some diet adjustment and use of an SGLT2 inhibitor, people frequently lose 10 to 20lbs (and then plateau).

And on a cautionary note - some things to be aware of for those investigating canagliflozin and other SGLT2 inhibitors for anti-aging purposes:

Clinicians should be aware of the potential for the pharmacologic activity of SGLT2 inhibitors to persist long after the standard drug clearance period of five half‐lives, the typical duration used to guide pre‐operative medication recommendations.

And:

Rare Risk for ketoacidosis - A Case Report

Sodium-glucose cotransporter-2-inhibitors are relatively new substances for treating patients with diabetes mellitus. Not least because of their rare, but severe side effects - especially euglycemic ketoacidosis - anaesthesiologists and physicians in intensive care should know about the pharmacologic properties and risk profile of sodium-glucose cotransporter-inhibitors. The present case report demonstrates typical laboratory findings of severe euglycemic ketoacidosis in a patient with only unspecific symptoms under therapy with gliflozins in the perioperative period.

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The present study examined if controlling hyperglycemia with empagliflozin, or given in combination with lisinopril, slows the progression of renal injury in hypertensive diabetic rats. Studies were performed using hypertensive streptozotocin-induced type 1 diabetic Dahl salt-sensitive (STZ-SS) rats and in deoxycorticosterone-salt hypertensive type 2 diabetic nephropathy (T2DN) rats. Administration of empagliflozin alone or in combination with lisinopril reduced blood glucose, proteinuria, glomerular injury, and renal fibrosis in STZ-SS rats without altering renal blood flow (RBF) or glomerular filtration rate (GFR). Blood pressure and renal hypertrophy were also reduced in rats treated with empagliflozin and lisinopril. Administration of empagliflozin alone or in combination with lisinopril lowered blood glucose, glomerulosclerosis, and renal fibrosis but had no effect on blood pressure, kidney weight, or proteinuria in hypertensive T2DN rats. RBF was not altered in any of the treatment groups, and GFR was elevated in empagliflozin-treated hypertensive T2DN rats. These results indicate that empagliflozin is highly effective in controlling blood glucose levels and slows the progression of renal injury in both hypertensive type 1 and type 2 diabetic rats, especially when given in combination with lisinopril to lower blood pressure.

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