Abstract：
PURPOSE OF REVIEW:The micro/macrovascular complications of diabetes cause considerable morbidity and premature mortality. The SGLT2 inhibitors are the first diabetes medications with significant benefits on microvascular disease (nephropathy) and macrovascular cardiovascular disease. In this review, we evaluate one of the potential mechanisms for these cardiorenal benefits-the production of ketones, their benefits, and risks. RECENT FINDINGS:In recent cardiovascular outcome trials (CVOTs), the SGLT2 inhibitors demonstrated significant cardiorenal benefits and they are now approved to reduce CV events/death, heart failure hospitalization, and progression to end-stage renal disease. Glucosuria induced by the SGLT2 inhibitors leads to increased ketone production. Ketones are an efficient fuel source and can improve myocardial and renal function. Further, the ketone body beta-hydroxybutyrate exhibits anti-inflammatory/anti-oxidative actions, which favorably impact myocardial and renal remodeling/fibrosis. Uncontrolled ketogenesis leads to ketoacidosis, especially during conditions of acute illness and excessive insulin dose reductions. The SGLT2 inhibitors have demonstrated significant cardiorenal benefits in large CVOTs. Studies are in progress to elucidate whether SGLT2 inhibitor-induced low-grade hyperketonemia contributes to these benefits.
journal_name
Curr Diab Repjournal_title
Current diabetes reportsauthors
Ekanayake P,Hupfeld C,Mudaliar Sdoi
10.1007/s11892-020-01359-zsubject
Has Abstractpub_date
2020-11-23 00:00:00pages
74issue
12eissn
1534-4827issn
1539-0829pii
10.1007/s11892-020-01359-zjournal_volume
20pub_type
杂志文章,评审abstract：PURPOSE OF REVIEW:The increasing prevalence of type 2 diabetes is driving the boundaries of clinical diabetes care outside of the traditional office setting. The purpose of this paper will be to review recent technological advances in the medical management of people with type 2 diabetes, spanning the spectrum of care ...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1278-3
更新日期：2019-12-20 00:00:00
abstract：:Cardiovascular disease is a leading cause of death and disability in patients with diabetes or metabolic syndrome (MS). The available data suggest that many patients with diabetes or MS already have vascular abnormalities by the time they are diagnosed with their metabolic disorder. Endothelial dysfunction (ED), which...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-003-0019-8
更新日期：2003-08-01 00:00:00
abstract：:Although there is clear evidence from experimental diabetic neuropathy (DN) models that the multiple pathways involved in neuronal degeneration cause overproduction of reactive oxygen species, oxidative stress, and cellular dysfunction, therapeutic approaches addressing these mechanisms have not yet provided a basis f...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-003-0007-z
更新日期：2003-12-01 00:00:00
abstract：:Since their introduction, insulin analogues are the preferred choice for short-acting insulin due to their superior pharmacologic profiles, leading to greater flexibility and convenience of dosing and, thus, greater patient satisfaction and improved quality of life. Over the past few years, clinical experience with in...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-010-0160-0
更新日期：2011-02-01 00:00:00
abstract：:Although numerous chemokine/chemokine receptor pathways have been described to be implicated in the pathogenesis of type 1 diabetes (T1D), the CXCR1/2 axis has recently been proved to be crucial for leucocyte recruitment involved in insulitis and β cell damage. Multiple strategies blocking the CXCR1/2 pathway are avai...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0638-x
更新日期：2015-10-01 00:00:00
abstract：:Metabolomics is the snapshot of all detectable metabolites and lipids in biological materials and has potential in reflecting genetic and environmental factors contributing to the development of complex diseases, such as type 1 diabetes. The progression to seroconversion to development of type 1 diabetes has been stud...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-016-0820-9
更新日期：2016-12-01 00:00:00
abstract：PURPOSE OF REVIEW:Diabetic kidney disease (DKD) is the leading cause of kidney failure in the USA, representing ~ 44% of all cases of kidney failure. Advancements in both glucose management and inhibitors of the renin-angiotensin system have significantly improved prognosis for individuals with DKD, yet DKD continues t...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-020-01314-y
更新日期：2020-06-16 00:00:00
abstract：:Continuous glucose monitoring (CGM) is an emerging technology that provides a continuous measure of interstitial glucose levels. In addition to providing a more complete pattern of glucose excursions, CGMs utilize real-time alarms for thresholds and predictions of hypo- and hyperglycemia, as well as rate of change ala...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-013-0398-4
更新日期：2013-10-01 00:00:00
abstract：:Microalbuminuria clusters with the metabolic syndrome, and both conditions predict cardiovascular disease mortality. The reported relationships of microalbuminuria with the individual components of the metabolic syndrome (i.e., hyperglycemia, insulin resistance, hypertension, dyslipidemia, abdominal obesity) are varia...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-003-0058-1
更新日期：2003-02-01 00:00:00
abstract：PURPOSE OF REVIEW:Obesity in the older adult is a burgeoning health epidemic that leads to increased morbidity, disability, and institutionalization. This review presents a brief overview of geriatric-specific consequences of obesity by highlighting the risks and benefits of intentional weight loss. RECENT FINDINGS:In...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1249-8
更新日期：2019-11-04 00:00:00
abstract：PURPOSE OF REVIEW:A growing body of epidemiological and experimental data indicate that nutritional or environmental stressors during early development can induce long-term adaptations that increase risk of obesity, diabetes, cardiovascular disease, and other chronic conditions-a phenomenon termed "developmental progra...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1170-1
更新日期：2019-07-20 00:00:00
abstract：PURPOSE OF REVIEW:Type 1 diabetes (T1D) is an autoimmune disease marked by β-cell destruction. Immunotherapies for T1D have been investigated since the 1980s and have focused on restoration of tolerance, T cell or B cell inhibition, regulatory T cell (Treg) induction, suppression of innate immunity and inflammation, im...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-017-0878-z
更新日期：2017-07-01 00:00:00
abstract：:Hyperglycemia is common following organ transplantation, regardless of the pre-transplant diabetes status. Transient post-transplant hyperglycemia and/or new-onset diabetes after transplantation (NODAT) are common and are associated with increased morbidity and mortality. NODAT and type 2 diabetes share similar charac...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0707-1
更新日期：2016-02-01 00:00:00
abstract：:Contrast-induced nephropathy (CIN) continues to be a significant complication of the increasing use of iodinated contrast media. There have been few new insights into pathogenesis; despite multiple strategies aimed at prophylaxis, very few have proven efficacious. This article reviews our current knowledge regarding C...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-007-0077-4
更新日期：2007-12-01 00:00:00
abstract：:Both type 1 and type 2 diabetic patients have an increased incidence of ischemic heart disease and congestive heart failure. Cardiovascular disease accounts for up to 80% of the excess mortality in patients with type 2 diabetes. The burden of cardiovascular disease is especially pronounced in diabetic women. Factors t...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-003-0068-z
更新日期：2003-06-01 00:00:00
abstract：PURPOSE OF REVIEW:The Diabetes Prevention Program (DPP) is an evidence-based lifestyle change program for prediabetes that is associated with a 58% reduction in 3-year diabetes incidence, and it has been supported by the American Medical Association and the Centers for Disease Control and Prevention. However, 9 in 10 p...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-018-1034-0
更新日期：2018-08-08 00:00:00
abstract：PURPOSE OF REVIEW:The goal of this review is to provide updates on congenital (neonatal) diabetes from 2011 to present, with an emphasis on publications from 2015 to present. RECENT FINDINGS:There has been continued worldwide progress in uncovering the genetic causes of diabetes presenting within the first year of lif...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-018-1016-2
更新日期：2018-06-13 00:00:00
abstract：:Type 2 diabetes is the result of a progressive impairment of pancreatic beta-cell function in the setting of worsening insulin resistance. Studies in high-risk populations have demonstrated that during progression to diabetes, beta cells have declining function and lose the first phase of insulin secretion, resulting ...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-004-0019-3
更新日期：2004-06-01 00:00:00
abstract：:Insulin analogues were designed to provide more physiologic pharmacokinetic and pharmacodynamic properties compared with human insulin. This article examines the literature over a 2-year period, focusing on studies directly comparing analogue and human insulin in controlled clinical trials and large observational stud...
journal_title：Current diabetes reports
pub_type： 杂志文章,meta分析
doi：10.1007/s11892-010-0104-8
更新日期：2010-06-01 00:00:00
abstract：:Diabetic nephropathy is a clinical syndrome of albuminuria, declining glomerular filtration rate, and increased risk of cardiovascular disease. Multiple mechanisms have been implicated in its pathogenesis. Although current therapies appear to be effective, treatment of diabetic nephropathy remains suboptimal. This rev...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-005-0057-5
更新日期：2005-12-01 00:00:00
abstract：:Diabetic retinopathy (DR) is a vision-threatening complication of diabetes. Timely diagnosis and intervention are essential for treatment that reduces the risk of vision loss. A good color retinal (fundus) photograph can be used as a surrogate for face-to-face evaluation of DR. The use of computers to assist or fully ...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-013-0393-9
更新日期：2013-08-01 00:00:00
abstract：PURPOSE OF REVIEW:A systematic review was conducted of family-based interventions to improve glycemic control, adherence, and psychosocial outcomes in children and adolescents with type 1 diabetes (T1D). Electronic databases were searched for randomized controlled trials (RCTs) published since the seminal Diabetes Cont...
journal_title：Current diabetes reports
pub_type： 杂志文章
doi：10.1007/s11892-018-0981-9
更新日期：2018-02-19 00:00:00
abstract：:Both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) have been associated with reduced performance on multiple domains of cognitive function and with evidence of abnormal structural and functional brain magnetic resonance imaging (MRI). Cognitive deficits may occur at the very earliest stages of diabetes and are fur...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-016-0775-x
更新日期：2016-09-01 00:00:00
abstract：:These data are a review of previously published data. Initially, body composition was estimated in 186 neonates. Fat- free mass (FFM), which constituted 86% of birth weight, accounted for 83% of the variance in birth weight; fat mass (FM), which constituted 14% of birth weight, accounted for 46% of the variance in bir...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-001-0013-y
更新日期：2001-08-01 00:00:00
abstract：:Neonatal hypoglycemia is an important consequence for the infant of the mother with diabetes. We have reviewed 24 published papers of various protocols for control of glucose in pregnant diabetic women during labor and delivery including our own published work. A relationship of maternal glucose during labor and neona...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-013-0450-4
更新日期：2014-01-01 00:00:00
abstract：:In nondiabetic individuals, a poor response to an endothelium-dependent vasodilator in coronary vessels has been shown to increase the likelihood of a future cardiovascular event. Such prospective data are not as yet available in patients with type 1 or type 2 diabetes. However, consistent with the greatly increased c...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-002-0054-x
更新日期：2002-02-01 00:00:00
abstract：:Low- and middle-income countries (LMICs) face a rapid change in the nutrition transition toward increases in noncommunicable diseases. Underlying this transition are shifts in the agricultural system and the subsequent growth of the modern retail and food service sectors across all regions and countries, a change in t...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-015-0631-4
更新日期：2015-09-01 00:00:00
abstract：PURPOSE OF REVIEW:Pancreas transplantation enables complete patient independence from exogenous insulin administration and increases both patient survival and quality of life. Despite this, there has been a decline in pancreas transplantation for the past 20 years, influenced by changing donor demographics with more hi...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1165-y
更新日期：2019-07-10 00:00:00
abstract：:Cardiovascular disease is a significant cause of morbidity and mortality in patients with diabetes mellitus (DM). DM is now recognized as a risk equivalent for coronary heart disease. The lipid profile in patients with type 2 DM is characterized by elevated triglycerides, low levels of high-density lipoprotein cholest...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-007-0036-0
更新日期：2007-06-01 00:00:00
abstract：PURPOSE OF REVIEW:To introduce recent advances in the understanding of diabetic retinopathy and to summarize current and emerging strategies to treat this common and complex cause of vision loss. RECENT FINDINGS:Advances in retinal imaging and functional analysis indicate that retinal vascular and neural pathologies e...
journal_title：Current diabetes reports
pub_type： 杂志文章,评审
doi：10.1007/s11892-019-1218-2
更新日期：2019-09-10 00:00:00
