SGLT2 Inhibitors: A New Class Of Diabetes Medications

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 offers further glucose control by allowing increased insulin sensitivity and uptake of glucose in the muscle cells, decreased gluconeogenesis and improved first phase insulin release from the beta cells.
It is proposed that in prehistoric times, we developed an elegant system for maximizing energy conservation and storage, due to lack of consistent food supplies. This system included reducing the activ Continue reading

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7 Ways Diabetes Affects Your Body

Diabetes is being called an epidemic for a reason. With more than 29 million Americans suffering from the disease, and diagnoses on the rise, the disease has quickly become one of the most common reasons for a visit to the doctor in the U.S. The most common form of the disease, type 2 diabetes can be a byproduct of modern lifestyles (think: more eating, less moving). This can result in the body becoming unable to use insulin, the hormone that normally regulates blood sugar, normally. When insulin function is out of whack, you can end up with sky-high blood glucose levels. While smart eating and exercise can both help to keep diabetes under control, many patients require oral medications or insulin injections as forms of treatment, too. That’s because type 2 diabetes can wreak real havoc on your health. Curious how? Watch the video to learn more about the seven ways type 2 diabetes can affect the body.
Diabetes is being called an epidemic for a reason. With more than 29 million Americans suffering from the disease, and diagnoses on the rise, the disease has quickly become one of the most common reasons for a visit to the doctor in the U.S.
The most common form of the disease, type 2 diabetes can be a byproduct of modern lifestyles (think: more eating, less moving). This can result in the body becoming unable to use insulin, the hormone that normally regulates blood sugar, normally. When insulin function is out of whack, you can end up with sky-high blood glucose levels.
RELATED: More Aggressive Type 2 Diabetes Treatment May Lead to a Longer, Healthier Life
While smart eati Continue reading

Diabetes and Sleep Apnea: How Sleep Affects Blood Glucose and Diabetes

Treat Apnea to Control Diabetes?
Sleep apnea can affect diabetes control in many ways. Struggling for air may put your body into fight-or-flight mode, releasing stress hormones that can raise blood glucose levels. If you're tired, you won't want to take that walk around the block after lunch. While you're at work, you might keep snacking to stay awake.
But can treating sleep apnea lead to better blood glucose control? Arvind Cavale, M.D., an endocrinologist in Feasterville, Pennsylvania, refers about 60 percent of his patients with type 2 diabetes for sleep studies. Cavale says treating sleep apnea reduces insulin resistance, improves alertness and motivation, and leads to more stable blood glucose levels. "We use correction of sleep apnea as a tool in controlling diabetes," he says.
Does This Sound Like You?
This is not a happy scenario: You're soooo tired. As soon as your head hits the pillow, you're asleep. But a little while later, someone nudges you awake. You go back to sleep. Just as you get into a deep sleep, you're nudged again. Sleep ... nudge ... sleep ... nudge. All night long.
The next day, you might wake up with a headache, snap at your family over breakfast, have trouble concentrating at work.
Irritability. Car accidents. Depression. High blood pressure. All because of those nightmarish nudges throughout the night.
If you have obstructive sleep apnea syndrome (OSA), you're getting those nudges. It's your body fighting for air. And sleep apnea may be one explanation for difficulty in controlling blood glucose and blood pressure levels.
With OSA, something part Continue reading

Diabetes Related Vertigo: Causes and Treatment

Vertigo is an abnormal sensation of motion that can happen when a person is sitting still or when their movement through space is inaccurately sensed.
Knowing where we are in space and how we are moving requires reliable information from five senses:
Our vision orients movement by taking cues from vertical objects and the horizon.
Our inner ear orients us to angular movements as we turn our head and to our acceleration as we move forward.
Touch orients us as our weight presses us against things (e.g., feet to the ground, butt to a chair).
Proprioception detects the position of our neck and limbs as we move.
Our hearing orients us to objects reflecting sound and to sound emitting objects.
Any impairment of these senses can lead to an experience of vertigo, disequilibrium or dizziness. Medical issues, including diabetes and heart disease, can potentially disrupt the functioning of these senses through nerve damage or circulation impairment.
Vertigo and Disequilibrium
Spinning vertigo is when either the environment appears to be spinning or a person feels that they are spinning within the environment. Positional vertigo is a spinning sensation occurring after a person repositions their head. A spinning sensation is often caused by inner ear problems.
Disequilibrium is the sensation of an impending fall or the need of external assistance to maneuver from here to there. Some people describe a floating sensation or that the floor or room appears tilted. This can be an inner ear or other motion-sensory issue, or it can originate in the central nervous system.
All experiences of ve Continue reading

Diabetes cured in mice. Are we next?

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According to the Center for Disease Control, 1.25 million people suffer from type 1 diabetes in the US alone. So far, it can only be managed with diet and regular doses of insulin, but scientists at UT Health San Antonio have invented a way of curing the disease in mice that may one day do the same for humans even with type 2 diabetes.
Type 1 diabetes is a particularly unpleasant condition. It occurs when the pancreas ceases to produce the insulin needed by the body to metabolize sugar and, until the invention of artificial insulin injections, it was as deadly as cancer. Type 2 is the less severe form of the disease, where the body produces insufficient insulin; it can often be managed through diet alone.
Add some color to your diet with this recipe for rainbow sheet pan veggies, using Eggland’s Bes...
Surprisingly, diabetes is an autoimmune disease. Insulin is made by specialized cells in the pancreas, called beta cells, and sometimes the body's immune system turns against itself and attacks these beta cells, destroying them. Diabetes results when this destruction is over 80 percent.
Invented by Bruno Doiron and Ralph DeFronzo, the UT Health technique uses gene transfer to alter cells in the pancreases of mice to make them think they're beta cells and start making insulin. This involves taking selected genes from external beta cells and using viruses as carriers to move them into the new host cells, in the diabetic pancreas.
According to DeFronzo, the altered cells then produce insulin, but only in the presence of sugar, which is how a functioning beta cell is Continue reading