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Diabetes Mellitus, Obesity, Lipoprotein Disorders and other Metabolic Diseases
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Renal glycosuria is glycosuria occurring with a normal blood glucose level. This occurs when glucose in the renal filtrate is incompletely reabsorbed because of reduced function of the glucose-reabsorbing transporters in the renal tubules. The class of oral diabetes drugs sodium-linked glucose transporter 2 inhibitors (SGLT2i) lower blood glucose by causing glycosuria.
Obesity and Lipid Disorders
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Christine San Giovanni, Janet Carter, Elise Rodriguez
A basic metabolic panel and urinalysis should be done with patients who have the diagnosis of HTN. Increased blood urea nitrogen (BUN) or creatinine or hematuria/proteinuria may reveal underlying kidney disease. Also, glycosuria is found with diabetes mellitus.
Protecting Pancreatic β-cells from Metabolic Insults
Published in Christophe Wiart, Medicinal Plants in Asia for Metabolic Syndrome, 2017
β-Sitosterol from the stem bark of Solanum surattense Burm.f given to streptozotocin-induced diabetic Wistar rats (glycemia > 250 mg/dL) orally at a dose of 20 mg/kg/day for 21 days lowered glycemia from 271.8 to 134 mg/dL (normal 85.1 mg/dL; glibenclamide at 0.3 mg/kg/day: 123.3 mg/dL) and increased serum insulin from 7.8 to 14.3 µU/mL (normal 17.8 µU/mL; glibenclamide at 0.3 mg/kg/day: 16.8 µU/mL.378 This regimen prevented glycosuria in diabetic animals.378 In the pancreas of treated rodents, the extract increased superoxide dismutase, catalase, glutathione, glutathione S-transferase and glutathione peroxidase and decreased lipid peroxidation.378 β-Sitosterol evoked a rejuvenation of pancreatic β-cells in diabetic rodents.378
Combined crystal-storing histiocytosis, light chain proximal tubulopathy, and light chain crystalline podocytopathy in a patient with multiple myeloma: a case report and literature review
Published in Renal Failure, 2023
Li Zhu, Lei Wang, Hongxia Shi, Lei Jiang, Xin Li, Chunying Shao, Yu Yan, Bao Dong, Wanzhong Zou, Li Zuo
Our patient presented with renal insufficiency and renal glycosuria. Although serum creatinine was significantly elevated, uric acid and serum phosphorus were normal, and hypokalemia persisted, which suggests the presence of Fanconi syndrome. Urinary protein was mainly low molecular weight protein, and albumin was also present. It was considered that the lesions mainly involved the proximal renal tubules and glomerulus. Due to the presence of monoclonal immunoglobulin, monoclonal gammopathy of renal significance (MGRS) or MM was suspected. Renal biopsy and bone puncture confirmed our hypothesis. It is suggested that monoclonal immunoglobulin-induced crystalline nephrology should be confirmed when Fanconi syndrome is complicated with monoclonal immunoglobulin. If there is evidence of glomerular involvement at the same time, caution should be taken with LCCP.
Potential molecular mechanism of action of sodium-glucose co-transporter 2 inhibitors in the prevention and management of diabetic retinopathy
Published in Expert Review of Ophthalmology, 2022
Lia Meuthia Zaini, Arief S Kartasasmita, Tjahjono D Gondhowiardjo, Maimun Syukri, Ronny Lesmana
SGLT2 inhibitors become a new therapeutic option for T2DM by selectively blocking SGLT2, reducing glucose reabsorption and increasing urinary glucose excretion. The therapeutically induced glycosuria ultimately reduces plasma glucose levels. SGLT2 inhibitors are recommended for the treatment of T2DM as a second or third-line therapy [8–11]. Currently, there are several types of SGLT2 inhibitors known to be in clinical development, such as dapagliflozin, canagliflozin, empagliflozin, ipragliflozin, luseogliflozin, tofogliflozin, ertugliflozin, and sotagliflozin. Both dapagliflozin and canagliflozin have been launched in the US and Europe, while ipragliflozin has been launched in Japan [14]. Apart from their effect on lowering blood sugar levels, SGLT2 inhibitors have also been shown to have other outcomes related to weight loss and lowering blood pressure. Many recent studies have shown that SGLT2 inhibitors have other beneficial effects, namely as organ protectors. This is because of its advantages in preventing heart and kidney damage associated with diabetes [15].
Cardiovascular benefit of SGLT2 inhibitors
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
The cell membrane, composed of hydrophobic lipids, is impermeable to glucose. Accordingly, glucose transport across cell membranes is mediated by two families of transporters [1]: glucose transporters (GLUT), which operate by facilitated diffusion, and SGLT, which actively transport glucose by coupling with sodium. In the kidney, the sodium-potassium ATPase pump in the proximal tubule cell utilizes ATP to send 3 sodium ions outward into the blood, while bringing 2 potassium ions inward. This movement in the proximal tubule cell produces a downhill sodium ion gradient from the outside to the inside. The SGLT proteins utilize the energy from this downhill sodium ion gradient to transport glucose across the apical membrane against an uphill glucose gradient [2]. Importantly, this process is saturable, leading to glycosuria when plasma glucose levels exceed 10.0–11.1 mmo/l (180–200 mg/dl), usually seen only in patients with uncontrolled diabetes mellitus [3]. Because of this, SGLT2 inhibitors do not cause hypoglycemia in those without diabetes mellitus, which is relevant to their use in patients without this diagnosis (Figure 1).