Pub Date : 2020-06-03DOI: 10.31031/IOD.2020.04.000582
F. Karachaliou
As obesity is principally a biologically mediated disease, biologically based interventions are often needed to counter the compensatory biological adaptations designed to maintain body weight at high levels. Pharmacotherapy can serve as an adjunctive treatment to lifestyle modification in some children and adolescents with obesity, especially those with severe forms of the disease and/or comorbidities. Despite the increasing number of anti-obesity drugs recently approved for the treatment of obesity in adults, few medications have been evaluated in terms of safety and efficacy in pediatric obesity. This mini review aims to provide some principles for the use of pharmacotherapy in pediatric obesity, summarizes results of some of the most important clinical trials on approved and “off-label” obesity medications and discusses some new options for the future of research on this field.
{"title":"Pharmacotherapy in Pediatric Obesity: Current Status and Future Prospects","authors":"F. Karachaliou","doi":"10.31031/IOD.2020.04.000582","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000582","url":null,"abstract":"As obesity is principally a biologically mediated disease, biologically based interventions are often needed to counter the compensatory biological adaptations designed to maintain body weight at high levels. Pharmacotherapy can serve as an adjunctive treatment to lifestyle modification in some children and adolescents with obesity, especially those with severe forms of the disease and/or comorbidities. Despite the increasing number of anti-obesity drugs recently approved for the treatment of obesity in adults, few medications have been evaluated in terms of safety and efficacy in pediatric obesity. This mini review aims to provide some principles for the use of pharmacotherapy in pediatric obesity, summarizes results of some of the most important clinical trials on approved and “off-label” obesity medications and discusses some new options for the future of research on this field.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114944332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-02DOI: 10.31031/IOD.2020.04.000581
E. Krzizek
Albuminuria in the context of diabetic nephropathy is a known complication of poorly controlled diabetes. Data of the Swedish Obese Study showed a reduction of albuminuria after bariatric surgery. On the other hand, Roux-en-Y gastric bypass carries the risk of protein malabsorption due to changes in the gut anatomy and physiology. In this case report we describe the results of a patient with both, diabetes mellitus type 1 and bariatric surgery. A 49-year old woman (height 157cm, weight 95kg, BMI 38.5kg/ m 2 ) with type 1 diabetes since 1983 underwent Roux-en-Y gastric bypass in 2005. She was admitted to our hospital due to generalized edema in December 2017. Routine check-up for bariatric patients was performed including blood tests after an overnight fasting and a urine sample. Amongst others HbA1c, creatinine, albumin and albumin-creatinine-ratio were evaluated. Yearly check-ups of these parameters were evaluated retrospectively since 1999. As expected, there was a significant weight loss after bariatric surgery (2005: 122kg, BMI 49.4kg/m 2 ; 2007: 80kg, BMI 32.4kg/m 2 ). Diabetes control has always been poor (HbA1c 8.9% (1999), 8.7% (2005), 10.3% (2007), 10.8% (2017)). Diabetic nephropathy and retinopathy have been known since 1999. Albuminuria was present before bariatric surgery and got worse over the years (ACR 32.6mg/g (1999), 158mg/g (2005), 2246.4mg/g (2014), 1336.1mg/g (2017). Furthermore, hypalbuminemia has been present before surgery and deteriorated subsequently (albumin 29.0% (1999), 60.6% (2005), 32.2% (2012), 21.6% (2017)). In this patient, albuminuria unexpectedly worsened after Roux-en-Y gastric bypass despite weight loss, most likely due to insufficient metabolic control. Following surgery, decreased protein absorption contributed to the severe hypoalbuminemia resulting in generalized edema. Thus, patients at high risk for hypoalbuminemia, especially those with progressive diabetic nephropathy, need to be carefully evaluated preoperatively and be offered non-malabsorptive bariatric procedures such as sleeve gastrectomy, if indicated.
{"title":"Severe Hypoalbuminemia Following Roux-En-Y Gastric Bypass in a Patient with Type 1 Diabetes","authors":"E. Krzizek","doi":"10.31031/IOD.2020.04.000581","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000581","url":null,"abstract":"Albuminuria in the context of diabetic nephropathy is a known complication of poorly controlled diabetes. Data of the Swedish Obese Study showed a reduction of albuminuria after bariatric surgery. On the other hand, Roux-en-Y gastric bypass carries the risk of protein malabsorption due to changes in the gut anatomy and physiology. In this case report we describe the results of a patient with both, diabetes mellitus type 1 and bariatric surgery. A 49-year old woman (height 157cm, weight 95kg, BMI 38.5kg/ m 2 ) with type 1 diabetes since 1983 underwent Roux-en-Y gastric bypass in 2005. She was admitted to our hospital due to generalized edema in December 2017. Routine check-up for bariatric patients was performed including blood tests after an overnight fasting and a urine sample. Amongst others HbA1c, creatinine, albumin and albumin-creatinine-ratio were evaluated. Yearly check-ups of these parameters were evaluated retrospectively since 1999. As expected, there was a significant weight loss after bariatric surgery (2005: 122kg, BMI 49.4kg/m 2 ; 2007: 80kg, BMI 32.4kg/m 2 ). Diabetes control has always been poor (HbA1c 8.9% (1999), 8.7% (2005), 10.3% (2007), 10.8% (2017)). Diabetic nephropathy and retinopathy have been known since 1999. Albuminuria was present before bariatric surgery and got worse over the years (ACR 32.6mg/g (1999), 158mg/g (2005), 2246.4mg/g (2014), 1336.1mg/g (2017). Furthermore, hypalbuminemia has been present before surgery and deteriorated subsequently (albumin 29.0% (1999), 60.6% (2005), 32.2% (2012), 21.6% (2017)). In this patient, albuminuria unexpectedly worsened after Roux-en-Y gastric bypass despite weight loss, most likely due to insufficient metabolic control. Following surgery, decreased protein absorption contributed to the severe hypoalbuminemia resulting in generalized edema. Thus, patients at high risk for hypoalbuminemia, especially those with progressive diabetic nephropathy, need to be carefully evaluated preoperatively and be offered non-malabsorptive bariatric procedures such as sleeve gastrectomy, if indicated.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114843962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-15DOI: 10.31031/IOD.2020.04.000580
Argyrios V Tsakalis
Hydroxychloroquine (HCQ) and Leflunomide (LE) are agents that are commonly used to treat rheumatoid arthritis. Type 2 Diabetes (DM2) patients are in increased risk of hypoglycemia. The present report documents a case of repeated dawn hypoglycemic episodes due to concomitant use of HCQ, LE and Repaglinide in a patient with Rheumatoid arthritis and DM2.
{"title":"Hypoglycemic Episodes Due to Synergistic Effect of Drugs in a Woman with Diabetes and Rheumatoid Arthritis","authors":"Argyrios V Tsakalis","doi":"10.31031/IOD.2020.04.000580","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000580","url":null,"abstract":"Hydroxychloroquine (HCQ) and Leflunomide (LE) are agents that are commonly used to treat rheumatoid arthritis. Type 2 Diabetes (DM2) patients are in increased risk of hypoglycemia. The present report documents a case of repeated dawn hypoglycemic episodes due to concomitant use of HCQ, LE and Repaglinide in a patient with Rheumatoid arthritis and DM2.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115576756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-05DOI: 10.31031/IOD.2020.04.000578
Fadwah M Al Sharif
Globally, non-alcoholic fatty liver disease (NAFLD) considered as a common chronic liver disorder [1]. Similarly, about 30% of European people have NAFLD [2]. Moreover, about 2550% of worldwide people have NAFLD which is the major cause of abnormal liver enzymes [3]. There is an association between NAFLD and obesity [4]. Abnormal immunological and systemic inflammation parameters are the key for NAFLD pathogenesis [5-8]. However, abnormal immune system performance not only induce NAFLD but also contributes progression and NAFLD associated disorders [9-11]. In addition, obesity is usually associated with abnormal immunological parameters values [12]. Altered immune system competence is usually a common finding associated with obesity subjects and the level of deterioration in immune system performance is related to obesity grade [13]. Similarly, about 30% of some malignant tumors are associated with obesity [14]. Many researchers reported abnormal values of immune system parameters among obese individuals [15-17].
{"title":"Immune System Response to Weight Loss among Obese Saudi Non-Alcoholic Fatty Liver Disease Subjects","authors":"Fadwah M Al Sharif","doi":"10.31031/IOD.2020.04.000578","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000578","url":null,"abstract":"Globally, non-alcoholic fatty liver disease (NAFLD) considered as a common chronic liver disorder [1]. Similarly, about 30% of European people have NAFLD [2]. Moreover, about 2550% of worldwide people have NAFLD which is the major cause of abnormal liver enzymes [3]. There is an association between NAFLD and obesity [4]. Abnormal immunological and systemic inflammation parameters are the key for NAFLD pathogenesis [5-8]. However, abnormal immune system performance not only induce NAFLD but also contributes progression and NAFLD associated disorders [9-11]. In addition, obesity is usually associated with abnormal immunological parameters values [12]. Altered immune system competence is usually a common finding associated with obesity subjects and the level of deterioration in immune system performance is related to obesity grade [13]. Similarly, about 30% of some malignant tumors are associated with obesity [14]. Many researchers reported abnormal values of immune system parameters among obese individuals [15-17].","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131596053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-05DOI: 10.31031/IOD.2020.04.000579
E. Monti, A. Rebora, E. Torre, M. Albertelli, C. Campana, F. Gatto, D. Ferone
Prevalence of both obesity and type 2 diabetes (T2DM) is increasing worldwide. Obesity, along with insulin resistance, predisposes individuals to low-grade chronic inflammation. Moreover, the combination of insulin resistance and hyperinsulinemia gives rise to the metabolic syndrome. The management of obesity can delay the progression to diabetes and first line treatment is represented by interventions on lifestyle (low-calorie diet and aerobic exercise). In obese patients with T2DM, weight loss improves glycaemic control and, therefore, reduces the antidiabetic drug need. While some older medications, including insulin, result in weight gain, the new molecules (glucagon-like peptide receptors agonists [GLP-1ra] and sodium-glucose co-transporter 2 inhibitors [SGLT2i]) result in weight loss. GLP-1ra has an anorexic action because it slows emptying gastric, whereas SGLT2i induce glycosuria by an osmotic diuresis associated with a loss of water. To date, metformin is used as a first-line anti-diabetic drug. This molecule is known to reduce hepatic gluconeogenesis, to decrease intestinal absorption of glucose and to improve peripheral glucose uptake. In obese patients with insulin resistance metformin can correct this alteration and promote weight loss. the same disease, the metabolic syndrome. Metformin is the first-line therapy in T2DM for its tolerability and efficacy in reducing glycated hemoglobin. Thanks to their different mechanism of action, metformin in association with GLP-1ra and/or SGLT2i probably represent the best choice for obese patients with T2DM.
{"title":"Treatment of Type 2 Diabetes in Subjects with Obesity: What is the Best Approach?","authors":"E. Monti, A. Rebora, E. Torre, M. Albertelli, C. Campana, F. Gatto, D. Ferone","doi":"10.31031/IOD.2020.04.000579","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000579","url":null,"abstract":"Prevalence of both obesity and type 2 diabetes (T2DM) is increasing worldwide. Obesity, along with insulin resistance, predisposes individuals to low-grade chronic inflammation. Moreover, the combination of insulin resistance and hyperinsulinemia gives rise to the metabolic syndrome. The management of obesity can delay the progression to diabetes and first line treatment is represented by interventions on lifestyle (low-calorie diet and aerobic exercise). In obese patients with T2DM, weight loss improves glycaemic control and, therefore, reduces the antidiabetic drug need. While some older medications, including insulin, result in weight gain, the new molecules (glucagon-like peptide receptors agonists [GLP-1ra] and sodium-glucose co-transporter 2 inhibitors [SGLT2i]) result in weight loss. GLP-1ra has an anorexic action because it slows emptying gastric, whereas SGLT2i induce glycosuria by an osmotic diuresis associated with a loss of water. To date, metformin is used as a first-line anti-diabetic drug. This molecule is known to reduce hepatic gluconeogenesis, to decrease intestinal absorption of glucose and to improve peripheral glucose uptake. In obese patients with insulin resistance metformin can correct this alteration and promote weight loss. the same disease, the metabolic syndrome. Metformin is the first-line therapy in T2DM for its tolerability and efficacy in reducing glycated hemoglobin. Thanks to their different mechanism of action, metformin in association with GLP-1ra and/or SGLT2i probably represent the best choice for obese patients with T2DM.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"52 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113964097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-17DOI: 10.31031/IOD.2020.04.000576
A. Chatterjee, N. Chakraborty
Different forms of virus induced infections are related to the enlarged risk of diabetogenic diseases in humans. Human cytomegalovirus infection has been advised by multiple studies to be one amongst the causative agents. HCMV infection has been linked to the development of both type 1 and type 2 diabetes as well as post-transplantation diabetes. The limited amount of available data indicates that active HCMV infection increases the risk of diabetes by either inhibiting the release of insulin from pancreatic cells or specifically destructing the pancreatic β cells. The mechanism is mainly attributed to the expression of pro-inflammatory cytokines that eventually results in programmed cell death or critical disturbances to the functioning of the β-cells.
{"title":"Association of Human Cytomegalovirus Infection with Different Forms of Diabetes","authors":"A. Chatterjee, N. Chakraborty","doi":"10.31031/IOD.2020.04.000576","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000576","url":null,"abstract":"Different forms of virus induced infections are related to the enlarged risk of diabetogenic diseases in humans. Human cytomegalovirus infection has been advised by multiple studies to be one amongst the causative agents. HCMV infection has been linked to the development of both type 1 and type 2 diabetes as well as post-transplantation diabetes. The limited amount of available data indicates that active HCMV infection increases the risk of diabetes by either inhibiting the release of insulin from pancreatic cells or specifically destructing the pancreatic β cells. The mechanism is mainly attributed to the expression of pro-inflammatory cytokines that eventually results in programmed cell death or critical disturbances to the functioning of the β-cells.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129515077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.31031/IOD.2020.03.000575
M. Haridas, A. Sabu
Ayurvedic fermentation as prescribed in classical texts is a versatile and powerful protocol for developing novel, traditional-like medicines. Ayurvedic medication, having a Prakriti (genetic) determinant, needs to be considered suitable for addressing metabolic disorders with immunologic implications, influenced by gut microbiome (as evidenced by the enterotypes). Obesity is a pathologic state on which the gut microbiota exercises influence in inflammatory and metabolic ways. When coupled with reverse pharmacology it would yield highly predictable results. It also bears potentials for redefining the protocol itself to deliver future products. In this article we essay on conceptualising the production and the prospect of developing new anti-obesity fermented nutraceutics/synbiotics to suit the prakriti of obese persons by prakriti-specific gut microbiome.
{"title":"Specific Anti-Obese Synbiotics to Suit Genetically Different Obese Persons","authors":"M. Haridas, A. Sabu","doi":"10.31031/IOD.2020.03.000575","DOIUrl":"https://doi.org/10.31031/IOD.2020.03.000575","url":null,"abstract":"Ayurvedic fermentation as prescribed in classical texts is a versatile and powerful protocol for developing novel, traditional-like medicines. Ayurvedic medication, having a Prakriti (genetic) determinant, needs to be considered suitable for addressing metabolic disorders with immunologic implications, influenced by gut microbiome (as evidenced by the enterotypes). Obesity is a pathologic state on which the gut microbiota exercises influence in inflammatory and metabolic ways. When coupled with reverse pharmacology it would yield highly predictable results. It also bears potentials for redefining the protocol itself to deliver future products. In this article we essay on conceptualising the production and the prospect of developing new anti-obesity fermented nutraceutics/synbiotics to suit the prakriti of obese persons by prakriti-specific gut microbiome.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116898710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.31031/iod.2020.03.000574
Daijie Chen
The beneficial effects of selenium (Se) as a trace element in chronic metabolic disease had been well reported in many studies. A change of Se level in human affects body metabolism significantly. The mechanism through which the Se improves diabetes, hyperglycemia and obesity is by relieving insulin resistance, reducing appetite and upregulating genes for fatty acid breakdown. The most important effect of Se is the regulation of the immune system. The present studies reveal that Se and Se-enriched products can be considered as promising candidates for the treatment of chronic metabolic diseases especially diabetes and obesity.
{"title":"Selenium Supplement for Obesity and Diabetes","authors":"Daijie Chen","doi":"10.31031/iod.2020.03.000574","DOIUrl":"https://doi.org/10.31031/iod.2020.03.000574","url":null,"abstract":"The beneficial effects of selenium (Se) as a trace element in chronic metabolic disease had been well reported in many studies. A change of Se level in human affects body metabolism significantly. The mechanism through which the Se improves diabetes, hyperglycemia and obesity is by relieving insulin resistance, reducing appetite and upregulating genes for fatty acid breakdown. The most important effect of Se is the regulation of the immune system. The present studies reveal that Se and Se-enriched products can be considered as promising candidates for the treatment of chronic metabolic diseases especially diabetes and obesity.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117119862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-14DOI: 10.31031/IOD.2020.03.000573
D. Melloul
& Diabetes Abstract Type 2 diabetes (T2DM) is frequently associated with elevated levels of lipids, in particular plasma free fatty acids and toxic lipid metabolites in muscle, liver, adipocytes, pancreatic islets and arterial tissues, contributing to insulin resistance and pancreatic islet β-cell dysfunction. The pathophysiology of T2DM is increasingly being linked with inflammatory mediators such as cytokines and chemokines as well as with changes in the number and activation state of macrophages/monocytes leading to β-cell dysfunction and subsequently to insulin insufficiency. The prevalent product of the cyclooxygenase 2 (COX-2) enzyme PGE2, controls numerous physiological functions through a family of cognate G protein-coupled receptors (EP1-EP4). The EP3 receptor which is selectively upregulated in islets of T2DM individuals, is upregulated under lipotoxic conditions and is involved in β-cell dysfunction and demise. This EP3 target presents a new approach to delay the progression of T2DM disease by preserving the
{"title":"The Role of Obesity-Induced Inflammation in Pancreatic -Cell Dysfunction and Death","authors":"D. Melloul","doi":"10.31031/IOD.2020.03.000573","DOIUrl":"https://doi.org/10.31031/IOD.2020.03.000573","url":null,"abstract":"& Diabetes Abstract Type 2 diabetes (T2DM) is frequently associated with elevated levels of lipids, in particular plasma free fatty acids and toxic lipid metabolites in muscle, liver, adipocytes, pancreatic islets and arterial tissues, contributing to insulin resistance and pancreatic islet β-cell dysfunction. The pathophysiology of T2DM is increasingly being linked with inflammatory mediators such as cytokines and chemokines as well as with changes in the number and activation state of macrophages/monocytes leading to β-cell dysfunction and subsequently to insulin insufficiency. The prevalent product of the cyclooxygenase 2 (COX-2) enzyme PGE2, controls numerous physiological functions through a family of cognate G protein-coupled receptors (EP1-EP4). The EP3 receptor which is selectively upregulated in islets of T2DM individuals, is upregulated under lipotoxic conditions and is involved in β-cell dysfunction and demise. This EP3 target presents a new approach to delay the progression of T2DM disease by preserving the","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126701320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-26DOI: 10.31031/IOD.2020.03.000571
Lei Zhou, H. Gong
Individuals with diabetes are not only with high risk of developing heart failure but also with increased risk of death [1]. Different types of hypoglycemic drugs have different cardiovascular safety, so it is necessary to evaluate the cardiovascular safety of new hypoglycemic drugs. In recent years, many large-scale randomized controlled trials on SGLT2 inhibitors for oral hypoglycemic agents such as (EMPA-REG OUTCOME (The Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes Trial); CANVAS Program (The Canagliflozin Cardiovascular Assessment Study Program); DEGLARE-TIMI 58 (The Dapagliflozin Effect on Cardiovascular Events -TIMI 58 Trial); DEFINE-HF Trial (The Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial) have shown that SGLT2 inhibitors could significantly reduce the hospitalization rate and the composite endpoint of cardiovascular mortality in patients with heart failure compared to the placebo group [2-5]. This effect persisted even in non-diabetic patients. The mechanisms responsible for the cardioprotective effects of SGLT2 inhibitors remain uncertain. This article summarizes the possible mechanisms of SGLT2 inhibitors in heart failure as follows. The Biological Role of SGLT2
糖尿病患者不仅发生心力衰竭的风险高，而且死亡风险也增加[1]。不同类型的降糖药具有不同的心血管安全性，因此有必要对新型降糖药的心血管安全性进行评价。近年来，许多关于SGLT2抑制剂用于口服降糖药的大规模随机对照试验，如EMPA-REG结局(恩格列净、心血管结局和2型糖尿病死亡率试验);CANVAS项目(canag列净心血管评估研究项目);达格列净对心血管事件的影响-TIMI 58试验;DEFINE-HF试验(The Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial)表明，与安慰剂组相比，SGLT2抑制剂可显著降低心力衰竭患者的住院率和心血管死亡率的综合终点[2-5]。这种效果甚至在非糖尿病患者中也持续存在。SGLT2抑制剂的心脏保护作用机制仍不确定。本文总结了SGLT2抑制剂在心力衰竭中的可能机制。SGLT2的生物学作用
{"title":"The Effects and the Mechanisms of Sodium Glucose Cotransporter-2 Inhibition in Heart Failure","authors":"Lei Zhou, H. Gong","doi":"10.31031/IOD.2020.03.000571","DOIUrl":"https://doi.org/10.31031/IOD.2020.03.000571","url":null,"abstract":"Individuals with diabetes are not only with high risk of developing heart failure but also with increased risk of death [1]. Different types of hypoglycemic drugs have different cardiovascular safety, so it is necessary to evaluate the cardiovascular safety of new hypoglycemic drugs. In recent years, many large-scale randomized controlled trials on SGLT2 inhibitors for oral hypoglycemic agents such as (EMPA-REG OUTCOME (The Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes Trial); CANVAS Program (The Canagliflozin Cardiovascular Assessment Study Program); DEGLARE-TIMI 58 (The Dapagliflozin Effect on Cardiovascular Events -TIMI 58 Trial); DEFINE-HF Trial (The Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial) have shown that SGLT2 inhibitors could significantly reduce the hospitalization rate and the composite endpoint of cardiovascular mortality in patients with heart failure compared to the placebo group [2-5]. This effect persisted even in non-diabetic patients. The mechanisms responsible for the cardioprotective effects of SGLT2 inhibitors remain uncertain. This article summarizes the possible mechanisms of SGLT2 inhibitors in heart failure as follows. The Biological Role of SGLT2","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128174682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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