Sodium-glucose cotransporter-2 inhibitors and their potential role in dementia onset and cognitive function in patients with diabetes mellitus: a systematic review and meta-analysis

Frontiers in Neuroendocrinology, Год журнала: 2024, Номер 73, С. 101131 - 101131

Опубликована: Фев. 16, 2024

This systematic review and meta-analysis aimed to determine the association between use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors dementia onset as well cognitive function in patients with diabetes mellitus. We comprehensively searched MEDLINE, Embase, CENTRAL databases select relevant studies published up August 2023. The SGLT-2 significantly lowers risk compared SGLT-2i non-users (Hazard ratio: 0.68, 95 % CI: 0.50-0.92). Furthermore, our findings indicated a positive effect inhibitor on score improvement, demonstrated by standardized mean difference 0.88 (95 0.32-1.44), particularly among populations mild impairment or dementia. indicate potential role reducing These underscore need for well-controlled large clinical trials future research this field.

Язык: Английский

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KDOQI US Commentary on the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of CKD

American Journal of Kidney Diseases, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 1, 2024

Язык: Английский

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13. Older Adults: Standards of Care in Diabetes—2025

Diabetes Care, Год журнала: 2024, Номер 48(Supplement_1), С. S266 - S282

Опубликована: Дек. 9, 2024

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating Standards annually, or more frequently as warranted. For a detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Язык: Английский

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Comparative effects of glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors on heart failure with preserved ejection fraction in diabetic patients: a meta-analysis

Cardiovascular Diabetology, Год журнала: 2024, Номер 23(1)

Опубликована: Авг. 31, 2024

Heart failure with preserved ejection fraction (HFpEF) is common in type 2 diabetes mellitus (T2D), leading to high morbidity and mortality. Managing HFpEF diabetic patients challenging limited treatments. Sodium-glucose co-transporter (SGLT2) inhibitors glucagon-like peptide-1 receptor agonists (GLP1-RA) have shown potential cardiovascular benefits. This meta-analysis compares the effects of GLP1-RA SGLT2 on T2D patients.

Язык: Английский

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Significance of Endothelial Dysfunction Amelioration for Sodium–Glucose Cotransporter 2 Inhibitor-Induced Improvements in Heart Failure and Chronic Kidney Disease in Diabetic Patients

Metabolites, Год журнала: 2023, Номер 13(6), С. 736 - 736

Опубликована: Июнь 8, 2023

Beyond lowering plasma glucose levels, sodium–glucose cotransporter 2 inhibitors (SGLT2is) significantly reduce hospitalization for heart failure (HF) and retard the progression of chronic kidney disease (CKD) in patients with type diabetes. Endothelial dysfunction is not only involved development cardiovascular (CVD), but also associated CKD. In diabetes, hyperglycemia, insulin resistance, hyperinsulinemia dyslipidemia induce endothelial dysfunction. SGLT2is have been shown to improve dysfunction, as assessed by flow-mediated vasodilation, individuals at high risk CVD. Along an improvement oxidative stress, inflammation, mitochondrial glucotoxicity, such advanced signaling glycation end products, nitric oxide bioavailability. The improvements endothelium-derived factors may play important role preventing coronary artery disease, microvascular diabetic cardiomyopathy, which cause HF, a retarding suppression HF CKD achieved might largely induced their capacity vascular function.

Язык: Английский

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EFFICACY AND SAFETY OF SGLT2 INHIBITORS IN THE TREATMENT OF HEART FAILURE: A COMPREHENSIVE REVIEW

International Journal of Health Science, Год журнала: 2025, Номер 5(4), С. 1 - 7

Опубликована: Янв. 15, 2025

Objective: To evaluate the efficacy and safety of sodium-glucose cotransporter type 2 inhibitors (SGLT2 inhibitors) in treatment heart failure.Method: Bibliographic review carried out PubMed database based on PVO strategy using terms "SGLT2 inhibitors", "heart failure", "efficacy" "safety", combined with Boolean operators AND OR.After screening, 15 articles were selected for critical analysis.Discussion: SGLT2 have demonstrated management failure, resulting significant clinical improvement a reduction adverse outcomes, including cardiovascular mortality failure-related hospitalizations.Final considerations: Despite benefits observed, more studies are needed to elucidate precise mechanisms action these drugs optimize their application specific subgroups patients.

Язык: Английский

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Temporal risk patterns of severe hypovolemia associated with sodium‐glucose cotransporter‐2 inhibitors in patients with type 2 diabetes mellitus: A self‐controlled case series study

Diabetes Obesity and Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Фев. 18, 2025

Abstract Aims We aimed to investigate the temporal risk patterns of severe hypovolemia induced by sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus. Materials and Methods conducted a self‐controlled case series using claims data from Japan. Patients who were prescribed SGLT2i for treating mellitus experienced enrolled. The primary analysis evaluated adjusted incidence rate ratios (IRRs) exposure periods (Days 1 30, Days 31 90, 91 180 ≥181) their corresponding 95% confidence intervals (CIs), calculated multivariable conditional Poisson regression model, relative that unexposed control period. Results A total 1200 new users 1334 events included. median follow‐up treatment 3.66 2.53 years, respectively. cohort was predominantly male (78.4%) age 54.1 years. higher associated observed particularly first 30 days (adjusted IRR 7.39, CI 6.09–8.96) initiation. Secondary analyses highlighted 22 28 15.24, 11.92–19.48) as highest period hypovolemia. Conclusions use hypovolemia, within initiation, during days.

Язык: Английский

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Challenges, current innovations, and opportunities for managing type 2 diabetes in frail older adults: a position paper of the European Geriatric Medicine Society (EuGMS)—Special Interest Group in Diabetes

European Geriatric Medicine, Год журнала: 2025, Номер unknown

Опубликована: Фев. 27, 2025

This position paper aims to address the challenges of managing type 2 diabetes mellitus (T2DM) in frail older adults, a diverse and growing demographic with significant variability health status. The primary research questions are: How can frailty assessment be effectively integrated into care? What strategies optimize glycaemic control outcomes for adults? innovative tools technologies, including artificial intelligence (AI), improve management this population? uses 5 I's framework (Identification, Innovation, Individualization, Integration, Intelligence) integrate care, proposing such as tools, novel therapies, digital AI systems. It also examines metabolic heterogeneity, highlighting anorexic-malnourished sarcopenic-obese phenotypes. proposed highlights importance tailoring targets levels, prioritizing quality life, minimizing treatment burden. Strategies leveraging are emphasized their potential enhance personalized care. distinct needs two phenotypes outlined, specific recommendations each group. calls holistic, patient-centered approach care ensuring equity access innovations life. need fill evidence gaps, refine healthcare integration better vulnerable

Язык: Английский

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The current role of SGLT2 inhibitors in type 2 diabetes and beyond: a narrative review

Expert Review of Endocrinology & Metabolism, Год журнала: 2023, Номер 18(4), С. 271 - 282

Опубликована: Май 4, 2023

ABSTRACTIntroduction Sodium-glucose cotransporter 2 inhibitors (SGLT2is, gliflozins), the most recent oral antihyperglycaemic agents, provide a cardiorenal protection, an effect independent of their glucose-lowering potency.Areas covered The potency SGLT2is was compared with that dipeptidyl peptidase-4 and glucagon-like peptide-1 receptor agonists, especially when added to metformin monotherapy. Main results cardiovascular/renal outcome trials were summarized in different populations: patients type diabetes mellitus (T2DM) or without established cardiovascular disease, (with T2DM) heart failure reduced preserved left ventricular ejection fraction) chronic kidney disease (CKD, including stage 4). Original papers meta-analyses these have consistently reported reduction hospitalization for (alone combined mortality) progression CKD, overall good safety profile.Expert opinion Global use has increased over time but remains suboptimal despite clinically relevant renal particularly likely benefit. proven both positive benefit–risk balance cost-effectiveness at risk patients. New prospects are expected other complications, i.e. metabolic-associated fatty liver neurodegenerative disorders.KEYWORDS: Cardiovascular diseasecardiovascular mortalitychronic diseasegliflozinguidelinesheart failureSGLT2 inhibitor Article highlights Glucose-lowering agents like offer protection independently glucose controlSGLT2is reduce at-risk populationsSGLT2i efficacy is now all-type fraction)The confirmed all subgroups estimated glomerular filtration rate, yet relative more marked higher baseline levels.These remarkable acceptable profile cost–benefit ratio gave prominent role international guidelines among (and without) diabetes.Declaration interestAJ Scheen received lecturer/scientific advisor/clinical investigator fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, Janssen, Merck Sharp & Dohme, NovoNordisk Sanofi. He worked as clinical TECOS, LEADER, HARMONY OUTCOME, PIONEER 6, EMPA-REG CANVAS-R DECLARE-TIMI 58 trials.The authors no affiliations financial involvement any organization entity interest conflict subject matter materials discussed manuscript apart those disclosed.Reviewer disclosuresPeer reviewers on this relationships disclose.Additional informationFundingThis paper not funded.

Язык: Английский

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mTOR and SGLT-2 Inhibitors: Their Synergistic Effect on Age-Related Processes

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(16), С. 8676 - 8676

Опубликована: Авг. 8, 2024

The aging process contributes significantly to the onset of chronic diseases, which are primary causes global mortality, morbidity, and healthcare costs. Numerous studies have shown that removal senescent cells from tissues extends lifespan reduces occurrence age-related diseases. Consequently, there is growing momentum in development drugs targeting these cells. Among them, mTOR SGLT-2 inhibitors garnered attention due their diverse effects: regulate cellular growth, metabolism, immune responses, while glucose reabsorption kidneys, resulting various beneficial metabolic effects. Importantly, may act synergistically by influencing senescence processes pathways. Although direct on combined effects inhibition limited, this review aims highlight potential synergistic benefits senescence.

Язык: Английский

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