Abstract:
:Understanding the role of the kidneys in type 2 diabetes mellitus (T2DM) has taken on an increased importance in recent years with the arrival of sodium-glucose co-transporter 2 (SGLT2) inhibitors - antihyperglycemic agents (AHAs) that specifically target the kidneys. This review includes an update on the physiology of the kidneys, their role in the pathophysiology of T2DM, and the mechanisms implicated in the development and progression of diabetic kidney disease, such as glomerular hyperfiltration and inflammation. It also discusses renal issues that could influence the choice of AHA for patients with T2DM, including special populations such as patients with concomitant chronic kidney disease. The most recent data published on the clinical efficacy and safety of the SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin and their effects on renal function are presented, showing how the renally mediated mechanisms of action of these agents translate into clinical benefits, including the potential for renoprotection. The observed positive effects of these agents on measures such as glucose control, estimated glomerular filtration rate, albumin-to-creatinine ratio, blood pressure, and body weight in patients both with and without impaired renal function suggest that SGLT2 inhibitors represent an important extension to the diabetes treatment armamentarium.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Weir MRdoi
10.1080/00325481.2016.1147926subject
Has Abstractpub_date
2016-01-01 00:00:00pages
290-8issue
3eissn
0032-5481issn
1941-9260journal_volume
128pub_type
杂志文章,评审abstract:OBJECTIVES:To investigate the associations of major and subthreshold depression with all-cause, cardiovascular disease and stroke mortality, and the extent to which health behaviour, medical comorbidity and functional disability explained the associations. METHODS:A cohort of 1070 persons aged ≥60 with Geriatric Menta...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1221319
更新日期:2016-09-01 00:00:00
abstract::Increasing evidence has contraindicated extended radical dissection of pancreatic adenocarcinoma (PC). With the recent improvement of perioperative management techniques and multimodal treatment strategy for PC, concomitant major vessel resection and reconstruction has thus been aggressively attempted in association w...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2015.1032180
更新日期:2015-04-01 00:00:00
abstract::The important causes of hypoglycemia unrelated to known diabetes are relatively few. Postprandial hypoglycemia is a relatively benign disorder. Fasting hypoglycemia is more serious and may be caused by metabolic disturbances or tumors. Several hereditary disorders cause hypoglycemia in infants and must be diagnosed an...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716369
更新日期:1990-07-01 00:00:00
abstract::Simple screening tests are available to detect abnormalities in the plasma coagulation system and platelet function. Prothrombin time reflects the integrity of the extrinsic system, while activated partial thromboplastin time indicates whether the intrinsic system is intact. Thrombin clotting time is a measure of the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715704
更新日期:1981-03-01 00:00:00
abstract::Exercise-induced bronchospasm is a common complication of asthma. Aggressive treatment of this conditions permits patients to maintain full activity despite their illness. Since most asthmatic patients are healthy except for an intermittent respiratory problem, providing them the opportunity to exercise in all weather...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701232
更新日期:1992-02-15 00:00:00
abstract:BACKGROUND:Asian Americans exhibit a high prevalence of chronic hepatitis B (CHB) compared with the general population in the United States. However, there are specific barriers to appropriate health care in the Asian American population, and CHB awareness is low. The aim of this study was to examine CHB awareness amon...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.09.2213
更新日期:2010-09-01 00:00:00
abstract::Preview Although no one theory on aging explains satisfactorily why or how this process occurs, we know that aging causes physiologic changes and a progressive decline of functional organ reserve. The implications of these changes are increasingly important as the elderly segment of the population grows. In this artic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946121
更新日期:1996-05-01 00:00:00
abstract::The complexity of coding in the auditory nerve makes it unlikely that a prosthesis for deaf persons can exactly duplicate the normal function of the ear. With recent advances, however, cochlear prostheses can perform some of the frequency-analysis functions of the normal ear. Cochlear prostheses are effective aids to ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11698797
更新日期:1984-11-15 00:00:00
abstract::In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit. :There ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715824
更新日期:1981-08-01 00:00:00
abstract::Chronic pain is considered one of the most prevalent causes of costly and disabling medical conditions. This review will define chronic pain and its categories and then will summarize the effectiveness and side effects associated with the use of various antidepressants, including the tricyclics, the selective serotoni...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1147925
更新日期:2016-01-01 00:00:00
abstract::Two distinct subpopulations in the pediatric age-group are particularly at risk for poisoning, and the substances likely to be ingested by each group differ. The method of critical care given here incorporates consideration of specific types of poisoning into an overall plan of general diagnostic and therapeutic measu...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716152
更新日期:1982-08-01 00:00:00
abstract::Abdominal paracentesis is a useful and safe technique in the evaluation of ascites. The withdrawn ascitic fluid should be routinely analyzed for appearance, blood cell count, and amylase and total protein concentrations; examined cytologically; and cultured. Results should either substantiate the clinical diagnosis or...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714844
更新日期:1978-05-01 00:00:00
abstract::The new oral anticoagulants have many advantages over vitamin K antagonists, but they are still associated with a troublesome incidence of major bleeding. Additionally, the absence of a reversal agent for the new oral anticoagulants is a barrier to their more widespread use. Currently, there are 3 potential reversal a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2014.11.2829
更新日期:2014-11-01 00:00:00
abstract::Minor burns are common but require early and appropriate care to avoid infection and scarring. Damage can be arrested by immersing the burn in cold water as soon as possible. The goals of care are then to remove dead tissue and protect viable tissue during healing. Very superficial burns require only application of an...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700548
更新日期:1989-01-01 00:00:00
abstract::Preview The ultrasensitive third-generation assay for thyrotropin (TSH) is now the "gold standard" for measuring thyroid activity. Who should be screened with it, and what further studies should be done if results are abnormal? Which patients with subclinical disease should receive treatment? Drs Brody and Reichard di...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946028
更新日期:1995-08-01 00:00:00
abstract::Pregabalin is one of the first-line treatments approved for the management of neuropathic pain (NeP). While many patients benefit from treatment with pregabalin, they are often treated with suboptimal doses, possibly due to unfamiliarity around prescribing the drug and/or side effects that can occur with up-titration....
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1857992
更新日期:2021-01-01 00:00:00
abstract::The mere presence of uterine fibroids is not, since qua non, an indication for their surgical removal. Knowing when not to operate is probably more important for the physician than knowing when to operate. It is easy to fall into diagnostic and therapeutic traps when uterine fibroids are known to be present, especiall...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::While a wide variety of thyroid function tests are currently available, all are sometimes abnormal in patients without thyroid disease. To interpret test results properly, the clinician needs to be aware of factors altering thyroid function tests. In every instance, the clinician needs to begin by asking whether the p...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-04-01 00:00:00
abstract::Effective management of blood-loss anemia depends on an understanding of the physiologic response to volume loss, the pattern of marrow response to acute depletion of red cell mass, and the controlling influence of iron supply. Each of these elements must be evaluated and incorporated into the plan of management. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1978.11714948
更新日期:1978-10-01 00:00:00
abstract::Over the past decade, despite the controversies surrounding prostate cancer screening, significant refinements have improved its application. PSA screening, although it has been questioned, appears to confer a mortality benefit and remains the most effective way to identify the possible presence of prostate cancer. Me...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1822067
更新日期:2020-12-01 00:00:00
abstract::Pneumococcal disease, which includes pneumococcal pneumonia, meningitis, and bacteremia, is associated with substantial morbidity, mortality, and health care costs in adults. Advanced age, chronic lung or cardiovascular disease, immunosuppressive conditions, and smoking increase the risk for infection. Despite the ava...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2009.11.2069
更新日期:2009-11-01 00:00:00
abstract::External otitis is directly related to patient habit patterns. It is easily treated, but the habits must be changed to effect permanent cure. Serous otitis media is the most common cause of conductive hearing loss, and its presence my predispose to development of purulent otitis media. Removal of middle ear fluid may ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11712183
更新日期:1977-05-01 00:00:00
abstract::Prompt and accurate diagnosis of patients presenting with symptoms suggestive of pulmonary arterial hypertension (PAH) is of outmost importance as delays in identifying this clinical entity have detrimental effects on both morbidity and mortality. Initial noninvasive assessment of these patients has traditionally incl...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1115715
更新日期:2016-01-01 00:00:00
abstract::Hair loss is a common problem likely to be encountered by a clinical practitioner. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. In the adult population, causes to be considered are alopecia areata and hair loss associated w...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699358
更新日期:1986-04-01 00:00:00
abstract::Given the present state of the art, any case of apparent pneumonia that is not responding to optimum therapy, or of "viremia" which appears to be progressively deteriorating, should be considered Legionnaires' disease and treated accordingly until proven otherwise. Titers for antibody to the disease in serum obtained ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715346
更新日期:1980-01-01 00:00:00
abstract::Drug-induced jaundice is relatively uncommon but can be a diagnostic puzzle. Because so many pharmaceutical classes and individual agents can produce jaundice, a thorough history of medications taken should be obtained from a patient presenting with jaundice. Jaundice usually resolves when the offending agent is disco...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1988.11700445
更新日期:1988-10-01 00:00:00
abstract::Seven bried case reports representing variations of atrial flutter point up important considerations bearing on diagnosis: situations predisposing individuals to atrial flutter with 1:1 atrioventricular conduction, the need for special care in placing ECG leads for continuous monitoring, the use of carotid sinus massa...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714577
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:Among a random sample of emergency department (ED) patients, we sought to determine the extent to which reported risk for human immunodeficiency virus (HIV) is related to ever having been tested for HIV. METHODS:A random sample of patients (aged 18-64 years) from an adult, urban, northeastern United States, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.01.2100
更新日期:2010-01-01 00:00:00
abstract::Oxygen therapy is tremendously valuable for patients with chronic respiratory insufficiency. A physician's prescription is needed to obtain Medicare, Medicaid, or insurance-company reimbursement, and certain guidelines must be followed: Patients are selected if significant hypoxemia is present, appropriate pharmacolog...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700464
更新日期:1988-11-01 00:00:00
abstract::Measurement of cerebrospinal fluid (CSF) lactate is a useful test when properly applied to the appropriate clinical situation and can offer information other CSF parameters cannot provide. Except for Gram's stain of CSF, lactate level is the most important CSF parameter in the early differentiation of viral (aseptic) ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716403
更新日期:1990-10-01 00:00:00