Identified evidence suggests that cardiovascular disease ( CVD ) prevention services should consider regulation of blood glucose as a key target for intervention .
The primary objective of this study was to analyze the most up-to- date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review .
Renal Hemodynamic Effect of Sodium-Glucose Cotransporter 2 Inhibition in Patients With Type 1 Diabetes Mellitus
Background — The primary objective of this mechanistic open-label , stratified clinical trial was to determine the effect of 8 weeks ’ sodium glucose cotransporter 2 inhibition with empagliflozin 25 mg QD on renal hyperfiltration in subjects with type 1 diabetes mellitus ( T1D ) . Methods and Results — Inulin ( glomerular filtration rate ; GFR ) and paraaminohippurate ( effective renal plasma flow ) clearances were measured in individuals stratified based on having hyperfiltration ( T1D-H , GFR ≥ 135 mL/min/1.73m2 , n=27 ) or normal GFR ( T1D-N , GFR 90–134 mL/min/1.73m2 , n=13 ) at baseline . Renal function and circulating levels of renin-angiotensin-aldosterone system mediators and NO were measured under clamped euglycemic ( 4–6 mmol/L ) and hyperglycemic ( 9–11 mmol/L ) conditions at baseline and end of treatment . During clamped euglycemia , hyperfiltration was attenuated by −33 mL/min/1.73m2 with empagliflozin in T1D-H , ( GFR 172±23–139±25 mL/min/1.73 m2 , P<0.01 ) . This effect was accompanied by declines in plasma NO and effective renal plasma flow and an increase in renal vascular resistance ( all P<0.01 ) . Similar significant effects on GFR and renal function parameters were observed during clamped hyperglycemia . In T1D-N , GFR , other renal function parameters , and plasma NO were not altered by empagliflozin . Empagliflozin reduced hemoglobin A1c significantly in both groups , despite lower insulin doses in each group ( P⩽0.04 ) . Conclusions — In conclusion , short-term treatment with the sodium glucose cotransporter 2 inhibitor empagliflozin  attenuated renal hyperfiltration in subjects with T1D , likely by affecting tubular-glomerular feedback mechanisms . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT01392560
Identified evidence suggests that cardiovascular disease ( CVD ) prevention services should consider regulation of blood glucose as a key target for intervention .
The primary objective of this study was to analyze the most up-to- date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review .