Abstract:
:Sodium-glucose cotransporter type 2 (SGLT-2) inhibitors (canagliflozin, dapagliflozin, empagliflozin) are new glucose-lowering agents that exert their therapeutic activity independently of insulin by facilitating glucose excretion through the kidneys. However, this simple renal mechanism that results in sustained glucose urinary loss leads to more complex indirect metabolic effects. First, by reduction of chronic hyperglycaemia and attenuation of glucose toxicity, SGLT-2 inhibitors can improve both insulin secretion by beta cells and peripheraltissue insulin sensitivity. In the case of canagliflozin, because of low-potency SGLT1 inhibition, a non-renal (intestinal) effect may also be considered, which may contribute to better control of postprandial hyperglycaemia, although this contribution remains to be better analyzed in humans. Second, chronic glucose loss most probably leads to compensatory mechanisms. One of them, although not well evidenced in humans, might involve an increase in energy intake, an effect that may limit weight loss in the long run. Another could be an increase in endogenous glucose production, most probably driven by increased glucagon secretion, which may somewhat attenuate the glucoselowering effect. Nevertheless, despite these compensatory mechanisms and most probably because of the positive effects of the reduction in glucotoxicity, SGLT-2 inhibitors exert clinically relevant glucose-lowering activity while promoting weight loss, a unique dual effect among oral antidiabetic agents. Furthermore, the combination of SGLT-2 inhibitors with other drugs that either have anorectic effects (such as incretin-based therapies) or reduce hepatic glucose output (like metformin) and, thus, may dampen these two compensatory mechanisms appears appealing for the management of type 2 diabetes mellitus.
journal_name
Diabetes Metabjournal_title
Diabetes & metabolismauthors
Scheen AJ,Paquot Ndoi
10.1016/S1262-3636(14)72689-8subject
Has Abstractpub_date
2014-12-01 00:00:00pages
S4-S11issue
6 Suppl 1eissn
1262-3636issn
1878-1780pii
S1262-3636(14)72689-8journal_volume
40pub_type
杂志文章,评审abstract:AIMS:Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular risk and diabetes independent of obesity. We investigated whether adipose tissue dysfunction is exacerbated due to increased tissue hypoxia. METHODS:Adipose tissue (AT) oxygenation was measured with a Clarke-type electrode (pATO2)...
journal_title:Diabetes & metabolism
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更新日期:2003-06-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:2001-12-01 00:00:00
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journal_title:Diabetes & metabolism
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更新日期:2001-09-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2014.05.004
更新日期:2014-11-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/j.diabet.2007.08.002
更新日期:2008-02-01 00:00:00
abstract:AIM:Different treatment strategies have been used to manage adolescents with poorly controlled type 1 diabetes. We investigated whether a brief elective hospital admission improves haemoglobin A(1c) (HbA(1c)) over 12 months. METHODS:We studied a retrospective cohort of adolescents with poorly controlled type 1 diabete...
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pub_type: 杂志文章
doi:10.1016/j.diabet.2013.04.003
更新日期:2013-12-01 00:00:00
abstract:AIM:As the treatment of hyperglycaemia during pregnancy with diet or insulin reduces the risk of adverse maternal outcomes and perinatal complications, screening for gestational diabetes mellitus (GDM) is included, albeit to variable extents, in all guidelines of care for pregnant women. The aim of the present investig...
journal_title:Diabetes & metabolism
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doi:10.1016/j.diabet.2014.11.008
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/j.diabet.2012.08.002
更新日期:2013-02-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 社论
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pub_type: 杂志文章
doi:10.1016/j.diabet.2018.03.007
更新日期:2019-04-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2013.02.005
更新日期:2013-04-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70138-6
更新日期:2004-11-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1016/j.diabet.2018.05.010
更新日期:2019-01-01 00:00:00
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pub_type: 历史文章,杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,多中心研究
doi:
更新日期:2001-06-01 00:00:00
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pub_type: 杂志文章
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journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2014.01.001
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,多中心研究
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更新日期:2014-04-01 00:00:00
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pub_type: 临床试验,杂志文章
doi:
更新日期:1997-02-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
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doi:10.1016/s1262-3636(07)70274-4
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journal_title:Diabetes & metabolism
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1999-09-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2013.03.006
更新日期:2013-09-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章,实务指引
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更新日期:2010-02-01 00:00:00
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journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:
更新日期:2002-06-01 00:00:00
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