scholarly journals Natriuretic Effect of Two Weeks of Dapagliflozin Treatment in Patients With Type 2 Diabetes and Preserved Kidney Function During Standardized Sodium Intake: Results of the DAPASALT Trial

Diabetes Care ◽  
2020 ◽  
pp. dc202604
Author(s):  
Rosalie A. Scholtes ◽  
Marcel H.A. Muskiet ◽  
Michiel J.B. van Baar ◽  
Anne C. Hesp ◽  
Peter J. Greasley ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Function ◽  
Sodium Intake ◽  
Natriuretic Effect

scholarly journals Natriuretic Effect of Two Weeks of Dapagliflozin Treatment in Patients With Type 2 Diabetes and Preserved Kidney Function During Standardized Sodium Intake: Results of the DAPASALT Trial

2020 ◽  
Author(s):  
Rosalie A. Scholtes ◽  
Marcel H.A. Muskiet ◽  
Michiel .J.B. van Baar ◽  
Anne C. Hesp ◽  
Peter J. Greasley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Kidney Function ◽  
Plasma Volume ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Extracellular Volume ◽  
Treatment Change ◽  
Urinary Glucose

<b>Background: </b> <p>Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce risk for heart failure hospitalization, potentially by inducing sodium excretion, osmotic diuresis and plasma volume contraction. Few studies have investigated this hypothesis, but none have assessed cumulative sodium excretion with SGLT2 inhibition during standardized sodium intake in patients with type 2 diabetes. </p> <p><b>Methods: </b></p> <p>DAPASALT (NCT03152084) was a mechanistic, non-randomized, open-label study in patients with type 2 diabetes with preserved kidney function, on a controlled standardized sodium diet (150 mmol/day). It evaluated the effects of dapagliflozin on sodium excretion, 24-hour blood pressure, and extracellular, intracellular and plasma volumes at start of treatment (ST; days 2-4), end of treatment (ET; days_12-14) and at follow-up (FU; days_15-18). </p> <p><b>Results:</b> </p> <p>Fourteen patients were included in the efficacy analysis. Mean [SD] baseline sodium excretion (150 [32] mmol/24-hours), did not significantly change during treatment (change at ST: -7.0 mmol/24-hours [95%CI: -22.4, 8.4]; change at ET 2.1 mmol/24-hours [95%CI: -28.8, 33.0]). Mean (SD) baseline 24-hour systolic blood pressure was 128 (10) mmHg and significantly reduced at ST (-6.1 mmHg [95%CI: -9.1, -3.1]; p<0.001) and ET (-7.2 mmHg [95%CI: -10.0, -4.3]; p<0.001). Dapagliflozin did not significantly alter plasma volume or intracellular volume, while extracellular volume changed at ST (-0.7 L [95%CI: -1.3, 0.1]; p=0.02). As expected, 24-hour urinary glucose excretion significantly increased during dapagliflozin treatment and reversed during FU. </p> <p><b>Conclusions:</b></p> <p>During standardized sodium intake, dapagliflozin reduced blood pressure without clear changes in urinary sodium excretion, suggesting that factors other than natriuresis and volume changes may contribute to the blood-pressure lowering effects. </p>

scholarly journals Natriuretic Effect of Two Weeks of Dapagliflozin Treatment in Patients With Type 2 Diabetes and Preserved Kidney Function During Standardized Sodium Intake: Results of the DAPASALT Trial

2020 ◽  
Author(s):  
Rosalie A. Scholtes ◽  
Marcel H.A. Muskiet ◽  
Michiel .J.B. van Baar ◽  
Anne C. Hesp ◽  
Peter J. Greasley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Kidney Function ◽  
Plasma Volume ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Extracellular Volume ◽  
Treatment Change ◽  
Urinary Glucose

<b>Background: </b> <p>Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce risk for heart failure hospitalization, potentially by inducing sodium excretion, osmotic diuresis and plasma volume contraction. Few studies have investigated this hypothesis, but none have assessed cumulative sodium excretion with SGLT2 inhibition during standardized sodium intake in patients with type 2 diabetes. </p> <p><b>Methods: </b></p> <p>DAPASALT (NCT03152084) was a mechanistic, non-randomized, open-label study in patients with type 2 diabetes with preserved kidney function, on a controlled standardized sodium diet (150 mmol/day). It evaluated the effects of dapagliflozin on sodium excretion, 24-hour blood pressure, and extracellular, intracellular and plasma volumes at start of treatment (ST; days 2-4), end of treatment (ET; days_12-14) and at follow-up (FU; days_15-18). </p> <p><b>Results:</b> </p> <p>Fourteen patients were included in the efficacy analysis. Mean [SD] baseline sodium excretion (150 [32] mmol/24-hours), did not significantly change during treatment (change at ST: -7.0 mmol/24-hours [95%CI: -22.4, 8.4]; change at ET 2.1 mmol/24-hours [95%CI: -28.8, 33.0]). Mean (SD) baseline 24-hour systolic blood pressure was 128 (10) mmHg and significantly reduced at ST (-6.1 mmHg [95%CI: -9.1, -3.1]; p<0.001) and ET (-7.2 mmHg [95%CI: -10.0, -4.3]; p<0.001). Dapagliflozin did not significantly alter plasma volume or intracellular volume, while extracellular volume changed at ST (-0.7 L [95%CI: -1.3, 0.1]; p=0.02). As expected, 24-hour urinary glucose excretion significantly increased during dapagliflozin treatment and reversed during FU. </p> <p><b>Conclusions:</b></p> <p>During standardized sodium intake, dapagliflozin reduced blood pressure without clear changes in urinary sodium excretion, suggesting that factors other than natriuresis and volume changes may contribute to the blood-pressure lowering effects. </p>

356-OR: Effect of Dulaglutide on Kidney Function–Related Outcomes in Type 2 Diabetes: Post Hoc Analysis from the REWIND Trial

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 356-OR
Author(s):  
JONATHAN E. SHAW ◽  
FADY T. BOTROS ◽  
RALEIGH MALIK ◽  
CHARLES ATISSO ◽  
HELEN M. COLHOUN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Function ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes—Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT)

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 689
Author(s):  
Chika Horikawa ◽  
Rei Aida ◽  
Shiro Tanaka ◽  
Chiemi Kamada ◽  
Sachiko Tanaka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Elderly Patients ◽  
Diabetes Complications ◽  
Vegetable Intake ◽  
Sodium Intake ◽  
Food Groups ◽  
High Sodium ◽  
Increased Risk

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.

Progression of diabetic kidney disease and trajectory of kidney function decline in Chinese patients with Type 2 diabetes

2019 ◽  
Vol 95 (1) ◽  
pp. 178-187 ◽  
Author(s):  
Guozhi Jiang ◽  
Andrea On Yan Luk ◽  
Claudia Ha Ting Tam ◽  
Fangying Xie ◽  
Bendix Carstensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Kidney Function ◽  
Diabetic Kidney Disease ◽  
Chinese Patients ◽  
Diabetic Kidney ◽  
Kidney Function Decline
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