Francisco Xavier Chávez Molina
Hello my name is francisco chavez and today i’m going to talk about empire liplochen and progression of kidney disease in type 2 diabetes introduction type 2 diabetes is a major risk factor for macrovascular and necrovascular disease kidney disease develops in approximately 35 percent of patients with type 2 diabetes and is associated with increased mortality
About 90 percent of people with diabetes have type 2 diabetes if you’ve got type 2 the insulin your pancreas makes can’t work properly or your pancreas can’t make enough insulin and we all need insulin to live it does an essential job it allows the glucose in our blood to enter our cells and fuel our bodies when you have type 2 diabetes your body still breaks down
Carbohydrate from your food and drink and turns it into glucose the pancreas responds to this by releasing insulin but because this insulin can’t work properly blood glucose levels keep rising so more insulin is released for some people with type 2 diabetes this can eventually tie the pancreas out meaning their body makes less and less insulin this causes even
Higher blood glucose levels so what does this mean well as your body can’t get enough glucose into your cells a common symptom of type 2 diabetes is feeling very tired other symptoms include needing to wee a lot feeling extremely thirsty cuts and grazes healing slowly and getting infections like thrush a lot of people don’t get any symptoms or they don’t notice
Them some people don’t think the symptoms are important so don’t ask for help this means that people can live with type 2 diabetes for up to 10 years before being diagnosed and over a long period of time high glucose levels in your blood can seriously damage your heart your eyes your feet and your kidneys these are known as the complications of diabetes but with
The right treatment and care the effects of diabetes and high glucose levels can be managed so if you’ve got any of these symptoms see a doctor as soon as possible there are different ways of treating type 2 diabetes some people can manage it by healthier eating being more active and losing weight eventually most people will need medication to bring their blood
Glucose down to a safe level whatever the treatment everyone with type 2 diabetes needs to learn how to live with it we help people do exactly that take a look at our website to see how we can help you our researchers are also investigating ways to put type 2 diabetes into remission so people’s blood glucose levels return to normal and stay there and they’re
Finding out more and more about type 2 diabetes so that we can do more to prevent it find new ways to treat it and one day find a cure applications in medicine empacliflozin a selective sodium glucose co-transporter to inhibitor reduce hyperglycemia in patients with type 2 diabetes by reducing the renal reabsorption of glucose thereby increasing or urinary
Glucose excretion sglt2 inhibitors explained in three minutes let’s begin the sglt2 inhibitors or sodium glucose co-transport ii inhibitors are one of the newer medications used to lower blood sugar in patients with type 2 diabetes these drugs can be identified by their suffix glyphlosin for instance empagliflozin or its brand name guardians or dipagliflozin
Or canagliflozin so how exactly do sglt2 inhibitors reduce blood glucose levels but firstly what is sglt2 sodium glucose cotransporter 2 is a protein found in the nephrons of the kidney approximately 160 to 180 grams of glucose is filtered from the glomerulus into the bowman’s capsule in a day sglt2 is a protein in the proximal convoluted tubule that acts to
Reabsorb filtered glucose back into the blood approximately 97 percent of filtered glucose is reabsorbed into the body through sglt2 and the remaining three percent is reabsorbed through another protein called sglt-1 as a result very little glucose is excreted through the urine as the name suggests sglt2 inhibitors such as ampagliflozone bind to sdlt2 and
Prevent the reabsorption of glucose back into the body as a result more glucose is excreted through the urine and this results in a reduction in blood glucose so to summarize sdlt2 inhibitors act to decrease glucose reabsorption in the kidneys resulting in increased excretion of glucose in the urine and this ultimately leads to a reduction in blood glucose
Additionally this medication may also help with weight loss and it is worth noting that sdlt2 inhibitors do not cause hypoglycemia looking at the side effects of sglt2 inhibitors urinary tract infections and genital fungal infections such as yeast infections are more common in patients taking this medication this is due to the increase in glucose in the urine
Which promotes bacterial growth in the urinary tract some patients may also experienced increased frequency of urination and this may lead to lower blood pressure due to the loss of fluids some patients may also notice a slight increase in their cholesterol values as well as some nausea pros and cons brush the use of empathy flexing has been associated with the
Lowering of located hemoglobin levels in patients with type 2 diabetes including those with the stage 2 or 3a chronic kidney disease and with reductions in weight and blood pressure without increasing in heart rate cons among the possible adverse effects that may occur from the use of this rock are the heat rotation vaginal yeast infection this infection of the
Penis the great thing about empire you know reg outcome it was a global study right was a very well conducted study and over 7 000 patients and as a result right not only we have great primary data but there was an opportunity to go back and keep learning from that data so one of the two studies that two analyses that we’re presenting here at ada are focused
On big unmanned means and that is chronic kidney disease and heart failure so let me tell you about uh the first of the studies right what we know is that when we look at empa when we look at giardians and the benefit on new onset or worsening of renal kidney disease right the effects were we’re independent of cardiovascular risk at baselines right in other
Words when we’re talking about a1c we’re talking about lipids right when we’re talking about blood pressure independent that those risks were controlled or not the effect of jargons on a chronic kidney disease was consistent was positive so that’s that’s that’s one of the studies the second one is that we look at hospitalization for heart failure and cv death
And a baseline we look at we really took a look at the different risk that the patient would have from a low risk to high risk and whether the effect was consistent right for each of those patients and across the continuum and we observe uh fortunately that the effect of jordan was consistent across you know whether whether you’re low risk you’re high risk the
The effect on the positive effect of reducing the risk of hospitalization for heart failure and cv death was consistent now you would think why is this important um you know renal disease right it’s it’s it’s a big unmet need and 15 of the u.s population a real decision the number one reason of renal failure heart failure is also a big unmet need here in the
U.s we have almost 6 million people and unfortunately is a disease that has a high morbidity and mortality so if you think about that fifty percent five zero of people that are diagnosed with heart failure we will die within five years so as you can imagine you know it’s a big unmet need and in a way it’s very reassurance because as you know we you know this
Is as i clarified before this was a sub-study post-hoc studies after empirical results but in a way they’re very reassuring very informative because we are doing the cv outcome studies for heart failure right and also for for kidney right the emperor program and the impact kidney program so in a way this is something really relevant for for the for the medical
Audience issue applied in ecuador it is necessary to announce to health professionals and patients about this new risk and to infer about the necessary measures to prevent their appearance because information has been released on an increased risk of non-traumatic amputation especially in the talks in conclusion among patients with type 2 diabetes who were at
High risk for cardiovascular events the use of empathy closing was associated with a slower progression of kidney disease than was placebo when added to standard keratin embolic leucine was also associated with a significantly lower risk of clinically relevant renal events the emperor’s study was a study testing the efficacy of impact glyphosate in patients
With diabetes and for the first time after 25 years we have a drug that showed a reduction in mortality and mobility but not just overall mortality but also the occurrence of new heart failure cases this is very important because of the safety concerns that we had with previous drugs like the glitter zones or the some of the glyptons and therefore the results
Of the emperor tell us that we have new cluster drugs that can be safely used in patients with heart failure of course there are new trials ongoing to address specifically the efficacy of the sdgl2 inhibitors in patients with heart failure and this the results of these studies will be important not just to confirm the results of empiric that seems to be also
Mirrored by the interim analysis of the other trials with the sdgl-2 inhibitors but also to teach us how to use friendly disk drugs in patients with heart failure one important point is that now cardiologists are empowered for to treat diabetic patients with heart failure we shouldn’t leave diabetes to other specialties and the guidelines specifically say that
Patients with diabetes should be supervised by a cardiologist thanks for your attention
Transcribed from video
Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes By Frank Molina
