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August 27, 2018Current Diabetes ReviewsOpen Access

Hormonal, Metabolic and Hemodynamic Adaptations to Glycosuria in Type 2 Diabetes Patients Treated with Sodium-Glucose Co-Transporter Inhibitors

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Key result

SGLT2i reduce CV morbidity and sustain glycemic control in T2D despite counter-regulatory metabolic adaptations.

Population

Type 2 Diabetes patients

Design

Review

Authors

ECEugênio CersósimoJMJohn M. Miles

Discussion

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Overview

Supports SGLT2i benefits in T2D despite adaptations; leaves open mechanistic and durability questions.

Structured PICO

P
Population
Type 2 Diabetes patients
I
Intervention
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i)

This review highlights the complex hormonal and metabolic adaptations, such as increased endogenous glucose production and lipolysis, induced by SGLT-2 inhibitors in patients with type 2 diabetes.

Limitations

  • Risk for keto-acidosis may limit the use of SGLT-2i
  • Metabolic adaptations limit the SGLT-2i therapeutic efficacy
  • Underlying mechanisms of cardiovascular benefits are not fully understood
  • No evidence for anti-atherosclerotic effects

Cite This Study

Cersósimo et al. (2018) conducted a review in Type 2 Diabetes. Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) was evaluated. Sodium-glucose cotransporter-2 inhibitors provide durable glycemic control and reduce cardiovascular morbidity in type 2 diabetes, despite inducing counter-regulatory metabolic adaptations.

synapsesocial.com/papers/6a0cf66aaea39375870ce761https://doi.org/10.2174/1573399814666180813124645
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Correction of hyperglycemia with phlorizin normalizes tissue sensitivity to insulin in diabetic rats.1987 · 815 citations
  2. 2Renal Glucose Production During Insulin-Induced Hypoglycemia1997 · 32 citations
  3. 3Renal lactate metabolism and gluconeogenesis during insulin-induced hypoglycemia.1998 · 30 citations
  4. 4SGLT2 Inhibitors and Cardiovascular Risk: Lessons Learned From the EMPA-REG OUTCOME Study2016 · 304 citations
  5. 5Insulin regulation of renal glucose metabolism in conscious dogs.1994 · 137 citations