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 127
- Downloads 0
Do we Need New Therapies for Diabetes?
Diabetes research and practice cluster (drug developers, payers, regulators and physicians) often (and especially in recent times) question the need of new therapies. Why would we need new therapies nowadays, when we hav...
Substitution of Chronic Insulin Therapy with Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Co-transporter-2 Inhibitors
Insulin is a very useful and widely used treatment for diabetes. Temporary insulin therapy improves glucose toxicity due to improved β-cell function of the pancreas. Upon achieving glycemic control, insulin treatment cou...
Rapid Improvement of Blood Glucose Level after Prosthetic Mandibular Advancement in a Patient with Diabetes Mellitus and Obstructive Sleep Apnea
Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is often associated with impaired glucose metabolism. However, the effects of Prosthetic Mandibular Advancement (PMA) on blood glucose levels and insulin resistance r...
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...
An Overview of Diabetes and its Complications
Diabetes mellitus is a metabolic disorder in which the body’s capacity to utilise glucose, fat and protein is disturbed due to impairment in insulin secretion and/or insulin resistance leading to chronic hyperglycaemia....