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Dapagliflozin and cardiovascular outcomes in type 2 diabetes

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And cardiovascular outcome in tied to the vedus definition thai to the and the third various molecules the size of animal carburetor metabolism that are created by polycemet it is association wide a relative or absolute impairment initially segregation and why bearings a degree of peripheral presenting to the action of insulin the polyphosis sodium called quadrupole

42 lce lt2 inventor are relatively new class cost anti-virus limit engine for the treatment air time to the video hi this is tom from in this video i’m going to be explaining how sg lt 2 inhibitors work now sglt2 inhibitors are used in type 2 diabetes to help to reduce the blood sugar levels they differ slightly from most anti-diabetic drugs which

Work by either increasing the insulin in the body or increasing the insulin sensitivity of the cells of the body and the objective of increasing the insulin or the insulin sensitivity is to get the body to take more glucose out of the blood and to store it in the tissues and that’s how they reduce blood sugar levels however in sglt2 inhibitors they work slightly

Differently they work by causing the kidneys to excrete glucose into the urine and by excreting glucose into the urine you reduce the amount of glucose or sugar that’s in the blood and the rest of the body for this video i’ll give you three examples the first is dapoglyphlosin the second is canagliflozin and the third is empiglyflosin and if you remember these

Three you’re unlikely to come across very many others but the clue is that all of them end with glyphlosin there’s only one real indication for these medications and that’s type 2 diabetes let’s go through the mechanism of action firstly in order to understand how sglt2 inhibitors work we need a very basic understanding of the function of the kidneys so let’s go

Through that briefly so to briefly go through those the kidney’s made up of about one million tiny tubes called nephrons application in medicine the polyphosis thing milligram of the healing prowess glee commits a control and reduce body weight and systematic law result when they are dead to use what but wrong therapy imparted a white inadequating contrality

To the precision lcbd and importation over the past two decades several studies have highlighted the importance of intensive glucose lowering therapy blood pressure control and statin use to reduce the risk of cardiovascular complications and mortality in patients with diabetes but the long-term trends of mortality and cardiovascular outcomes of patients with

Type 1 or type 2 diabetes as compared with the general population are unknown in a study of patients enrolled between 1998 and 2012 in the swedish national diabetes register a total of 36 869 patients with type 1 and 457 473 patients with type 2 diabetes were included along with matched controls from the general population the outcomes that were assessed were

All-cause mortality fatal coronary heart disease fatal cardiovascular disease and hospitalization for cardiovascular disease the rate of all-cause mortality declined among those with type 1 diabetes by 29 and in matched controls by 23 a difference that was not statistically significant the rate of hospitalization for cardiovascular disease decreased by 36

Percent among those with type 1 diabetes and by 9 among matched controls a decrease that was significantly greater for the diabetic group the rate of all-cause mortality decreased by 21 percent among those with type 2 diabetes and by 31 among matched controls a statistically significant difference that favored the control group the rate of hospitalization for

Cardiovascular disease decreased by 44 among those with type 2 diabetes and by 29 among matched controls a statistically significant difference that favored those with type 2 diabetes the authors conclude that mortality and cardiovascular disease have declined for patients with diabetes for most cardiovascular outcomes studied event rates have decreased at least

As quickly for patients with diabetes as from matched controls however as compared with match controls patients with type 2 diabetes had a smaller reduction in fatal cardiovascular outcomes full study results are available at pros and cons all right so let me move on now to treatment options for type 2 diabetes we have new anti-diabetic medicines i’m

Not going to cover them all but let’s first look at uh trials related to sgl t2 inhibitors maybe chris if you can just kind of tell us what that class is and and talk about some of the outcomes trials you don’t have to go into all the details but give us a broad view well this has been such an exciting time uh and the first of these trials was the emperor reg

Trial with epigloflosing an sglt2 inhibitor inhibits this exchanger so that glucose goes out in the urine but changes probably pressure in the glomeruli in the kidney you get weight loss and lots of other beneficial factors uh with the entire class and so out of surprise there was a significant reduction in pros the story so yet that using both the polyposing

And installing fm adventures the doctor emits your bill belize to see how well blue sugar levels are regulation or the longer term these measurements and show the average bloat sugar levels over the last a few months the story showed that the profession alpha this advantage in term of this a side effect union infection occurred in fixing of 100 punching a who

Received both wwe faulty and usually compared to one only a 4 of 100 function what residual insulin item user application in ecuador resided the inhibitor of sound dude will cause cotron for tie two a c e t l two used for the try me of the various and malarias try to have demonstration a cardio renal protector effects experimental is it a and different studies

Have established that the neuter of celt2 reduces the prolongation of hypertrophic cardiomyopathy fibrosis cardiac remodeling system diffusation and hair furies so my overall impression was that this trial like other sglt2 inhibitor trials again proved that there is substantial benefit in terms of reduction of heart failure hospitalization risk as you know there

Was a split a primary endpoint of this trial the mace endpoint did not reach statistical significance but the combined endpoint of cardiovascular death and heart failure hospitalization did reach the end point which was positive conclusion as the result alternate from the ucla posing have been followed concluded is used considerably a reduced a theory of cvd and

Improve the quality of life of pushing a y t to d to a do it evolution limit properties now we’ll move on to side effects and these mostly tie in with the precautions that we just discussed so urinary tract infection is one of the most common side effects you can experience because of the reasons we talked about and this is much more pronounced in women women

Are at a higher risk for utis compared to men in general so this can happen in up to six percent of patients and i would guess that this percentage would be much higher if we were talking just about females also those that are 75 years old and older are at an increased risk of getting this side effect as well genital infections are also possible and this is

Primarily in women nasopharyngitis is also listed as a possible side effect with around seven percent of people getting this and this is basically having symptoms that near a common cold stuffing nose and inflammation of the nasal cavities and when i see this listed as a side effect for a medication it makes me wonder if the drug is really causing this so in

The clinical trials if you get mesopharyngitis it is reported as a side effect now the question i have is is it really the drug causing this or are these people just getting a common cold i’m not really sure to be honest but it is listed as a side effect for farsiga you can also see an increase in urine output and nausea in a small percentage of people now one

Nice thing about farsiga is that hypoglycemia is not very common when it is used alone if you are taking other diabetic medications

Transcribed from video
Dapagliflozin and cardiovascular outcomes in type 2 diabetes By Miuriel Mv