Comparison of Diuretic Effects between Empagliflozin, a Sodium-Glucose Co-Transporter 2 Inhibitor With Osmotic Diuresis, and Tolvaptan, a Water Diuretic, in Two Type 2 Diabetic Patients Taking Sodium Diuretics
Journal Title: Diabetes Research – Open Journal - Year 2016, Vol 2, Issue 2
Abstract
Empagliflozin, one of sodium-glucose co-transporter 2 (SGLT2) inhibitors, has been demonstrated to have beneficial effects on cardiovascular morbidity and mortality in patients with type 2 diabetes at high risk for cardiovascular events. The mechanisms behind these benefits of empagliflozin are presumed to include osmotic diuresis, being rather close to water diuresis than sodium diuresis. Two cases are presented here, where distinct changes in urinary water and sodium excretion were seen immediately after replacing tolvaptan, a water diuretic, with empagliflozin. Case 1 with heart failure showed a large decrease in urinary sodium excretion with a slight decrease in urine volume. By contrast, Case 2 with nephrotic syndrome showed a large increase in urinary sodium excretion with an increase in urine volume. The differences were probably due to distinct diuretic effects of empagliflozin and tolvaptan in the presence of sodium diuretics as well as distinct pathological conditions. In addition, the amount of urine protein was reduced after the replacement in Case 2. SGLT2 inhibitors would be expected to have the potential to exert some beneficial effects other than lowering blood glucose levels by increasing urinary glucose excretion.
Authors and Affiliations
Yuji Aoki
Keywords
Related Articles
- EP ID EP550156
- DOI 10.17140/DROJ-2-128
- Views 116
- Downloads 0
Effect of Low Carbohydrate Diet on Type 2 Diabetic Patients and Usefulness of M-Value
Background: Debate between the Calorie Restriction (CR) and Low-Carbohydrate Diet (LCD) has been continued for several years. We have started LCD therapy for diabetic patients since 1999, and experienced good response to...
Regulatory T-Cells in Treatment of Type-1 Diabetes: Types and Approaches
Regulatory T-cells (Tregs) play important role in regulation of immune responses to self-antigens. Alterations in frequency and function of Tregs have been reported in Type 1 Diabetes (T1D) subjects. Tregs have the poten...
Use of High Resolution Digital Retinal Imaging in the Early Detection of Retinopathy in Type 1 Diabetes
Background: Type 1 Diabetes Mellitus is one of the most common endocrine and metabolic conditions worldwide, affecting nearly half a million children under the age of 15 years with an anticipated rise in incidence of 4%....
Reduced Sampling Schedules for Calculation of an Insulin Sensitivity Index from the Liquid Meal Tolerance Test
Background: The objective of this study was to evaluate the performance of the Matsuda index of insulin sensitivity (MISI) calculated using reduced sampling schedules. Methods: Relationships between MISI values from a Li...
Unanticipated Difficult Laryngoscopy in a Diabetic Patient Undergoing Coronary Artery Bypass Graft Surgery
Difficult laryngoscopy has been shown to be more frequent in cardiac surgery versus general surgery. In one study, the incidence of difficult laryngoscopy in cardiac surgery was almost double that compared to general sur...