Sglt2 Inhibitors Diabetes Care

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Practical Approach To Initiating Sglt2 Inhibitors In Type 2 Diabetes

, Volume 8, Issue5 , pp 953962 | Cite as Practical Approach to Initiating SGLT2 Inhibitors in Type 2 Diabetes Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an attractive novel therapeutic option for the treatment of type 2 diabetes. They block the reabsorption of filtered glucose in kidneys, mainly in proximal renal tubules, resulting in increased urinary glucose excretion and correction of the diabetes-related hyperglycemia. Beyond improving glucose control, SGLT2 inhibitors offer potential benefits by reducing body weight and blood pressure. On the basis of the efficacy demonstrated in clinical trials, SGLT2 inhibitors are recommended as second- or third-line agents for the management of patients with type 2 diabetes. Beneficial effects on kidney disease progression, cardiovascular and all-cause mortality, and hospitalization for heart failure have also been demonstrated with one SGLT2 inhibitor (empagliflozin). Potential adverse events resulting from their mechanism of action or related to concomitant therapies are reviewed. A treatment algorithm for the adjustment of concomitant therapies after initiating SGLT2 inhibitors is also proposed. ConcomitantInitiationManagem Continue reading >>

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  1. Melissa_Carver

    Hi all! I’m new here and to ketosis, 10 days in and feeling great!
    So I was listening to the 2 Keto Dudes episode on sweeteners and they were talking about how one sweetener or the other would “knock them out of ketosis.” How do you know when you’ve been knocked out of ketosis? Is it a blood sugar thing? Or are you using a ketone tester (blood/breath/urine strip) to verify?
    (Note: I’m T1D, 25 years now, diagnosed as a kid. I just started wearing my CGM again today to try to level off the blood sugars and adjust my basal rate in my insulin pump as needed. If I can tell by blood sugar if I’m knocked out of ketosis that would perfect and so easy for me!)

    Thanks in advance everyone!

  2. Ernest

    Most likely from experimentation to test tolerance.
    I did a protein tolerance experiment and I’d test my ketone readings, using the Precision Xtra, a few times after eating a large amount of protein .
    I bet one could do the same experiment with sweeteners.

  3. Rian

    There are a few sure ways to know if you are in ketosis. In my opinion the most reliable and easiest way is to acquire a blood ketone test meter. Many people here like the Abbott Precision Xtra. The strips to test ketones are a few bucks each but if you try eBay you can usually get them a little cheaper. You will have to do a fair amount of testing in the beginning to see what foods do what to your ketone levels but after awhile you’ll become familiar with the do’s and don’t and will only need to test or occasion.

    Testing for ketones isn’t a requirement but it is nice to know what’s going on without resorting to guessing.

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http://www.rxwiki.com/ DPP4 inhibitors Dipeptidyl Peptidase-4 Inhibitors (known as gliptins or DPP4 inhibitors) is a class of medications that are commonly used to treat diabetes. Gliptins work by preventing the release of glucagon- a naturally occurring substance in the body that raises blood sugar. Gliptins share a few common side effects including nausea, headache, minor skin rashes, and cold-like symptoms. These side effects are usually mild. Some examples of Gliptins include sitagliptin (the generic name for Januvia) and linagliptin (the generic name for Tradjenta). Talk to your doctor or pharmacist before starting a Gliptin as they can sometimes cause low blood sugar when not monitored properly or taken with certain other diabetic medications. Make to ask about early warning signs of low blood sugar and how to prevent it. In addition, Gliptins may cause joint pain that can be severe and disabling. Do not stop taking your medication, but contact your health care professional right away if you experience severe and persistent joint pain. It is always a good idea to ask questions about your medication if you are unsure or if you experience something out of the ordinary.

Sglt2 Inhibitors: A New Class Of Diabetes Medications

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of diabetic medications indicated only for the treatment of type 2 diabetes. In conjunction with exercise and a healthy diet, they can improve glycemic control. They have been studied alone and with other medications including metformin, sulfonylureas, nizagara 100, pioglitazone, and insulin. Editor’s Note: Since we first looked at this new drug class in April 2013, numerous studies have been done on the benefits and risks of the SGLT2 inhibitors. See below for a roundup of the new information, including the latest investigational drug in this class, Ertugliflozin. How SGLT2 Inhibitors Work SGLT2 is a protein in humans that facilitates glucose reabsorption in the kidney. SGLT2 inhibitors block the reabsorption of glucose in the kidney, increase glucose excretion, and lower blood glucose levels. SGLT2 is a low-affinity, high capacity glucose transporter located in the proximal tubule in the kidneys. It is responsible for 90% of glucose reabsorption. Inhibition of SGLT2 leads to the decrease in blood glucose due to the increase in renal glucose excretion. The mechanism of action of this new class of drugs also offer Continue reading >>

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  1. Andy030

    I'm kicking as and taking names with Intermittent Fasting and periodic low carb on top but my breath is scaring the children.
    Other than brush my teeth every 20 min, what the heck works?
    I'm constantly chewing gum and using breath spray and mouthwash but even then my wife says she can smell rotton iron on my breath.
    Years ago I heard about something you drink to take the smell out of your stomach but I can't remember what it is and I don't know if it can be used during fasting.
    I'm dying here...... well, others are

  2. CaptShady

    This is a cut and paste, but sounds worthy of trying:

    Good advice to lessen bad breath problems is drinking water and chewing parsley. If you drink more water you will go to the toilette more frequently, so more of the ketone bodies will leave your body with the urine.

  3. Steve Freides

    All sorts of weirdnesses are not uncommon when your body detoxifies - hopefully, it goes away with the passage of time, perhaps with eating cleaner along with IF and low-carb.
    I've heard this associated more with low-carb than with WD/IF type eating plans.
    KBNJ.COM - Steve Freides, RKC Team Leader

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Nsaids With Sglt2 Inhibitors In Diabetes May Cause Renal Injury

NSAIDs With SGLT2 Inhibitors in Diabetes May Cause Renal Injury Use of sodiumglucose cotransporter 2 (SGLT2) inhibitors for treatment of type 2 diabetes could potentially lead to hypoxic acute renal injury in the setting of dehydration and/or during use of nonsteroidal anti-inflammatory agents (NSAIDs) or radiocontrast studies, according to an Israeli research team. Hence, those circumstances should be avoided while people are taking the SGLT2 inhibitor class of glucose-lowering agents, Samuel N Heyman, MD, of Hadassah Hebrew University Hospitals, Jerusalem, Israel, and colleagues advise in an observation piece, published online January 27 in Diabetes Care. SGLT2 inhibitors, such as canagliflozin canagliflozin (Invokana, Janssen) and dapagliflozin (Farxiga/Forxiga, AstraZeneca), carry US Food and Drug Administration (FDA) label warnings about acute kidney injury. At the same time, empagliflozin (Jardiance, Boehringer Ingelheim), also an SGLT2 inhibitor, has been associated with long-term renoprotection in the EMPA-REG Outcome Study . And canagliflozin is being specifically tested in a diabetic kidney-disease population in the large multicenter randomized Evaluation of the Effects Continue reading >>

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Popular Questions

  1. saxybandgeek1

    I know the general rule is if you eat <25g carbs a day you should be in ketosis but I've also heard certain sweeteners can throw you out.
    I'll probably buy keto sticks eventually but I just don't want to spend the money right now

  2. Targash

    If you're eating 20 net grams and you're a human being you're in ketosis. Minimal carbs and brain still functions? Ketosis!

  3. WillowWagner

    You don't need keto sticks period. Some people have negative reactions to some foods. If too much of a particular food leaves you with carb cravings, or with stomach troubles, or changes in mood or sleep, that's likely a food sensitivity issues. It doesn't mean you've stopped making or burning ketones.
    You can get a blood ketone meter and spend $2 or $3 per test strip, unless you have a specific medical condition to address, that's a lot of money to prove what you already know.

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