Influence of Sodium Glucose Cotransporter 2 Inhibition on Physiological Adaptation to Endurance Exercise Training

Newman, Alissa A; Grimm, Nathan C.; Wilburn, Jessie R; Schoenberg, Hayden M.; Trikha, S. Raj J.; Luckasen, Gary J.; Biela, Laurie M.; Melby, Christopher L.; Bell, Christopher

doi:10.1210/jc.2018-01741

Cited by 32 publications

(43 citation statements)

References 67 publications

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“…Body composition was assessed using dual energy X-ray absorptiometry (DEXA: Hologic, Discovery W, QDR Series, Bedford, MA, USA), as previously described [24]. In addition, body mass was determined using a physician's digital scale, and waist circumference was measured midway between the lower border of the costal margin and the uppermost border of the iliac crest.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, body mass was determined using a physician's digital scale, and waist circumference was measured midway between the lower border of the costal margin and the uppermost border of the iliac crest. Peak oxygen consumption (VO 2peak ) was determined via indirect calorimetry (Parvo Medics, Sandy, UT, USA) during incremental stationary cycle ergometer exercise to volitional fatigue, as previously described [24,25].…”

Section: Methodsmentioning

confidence: 99%

“…Immediately following the measurement of RMR, participants ingested 75 g of glucose diluted in 300 mL water; venous blood was sampled prior to ingestion and systematically over the next two hours for the determination of circulating concentrations of glucose (2300 STAT Plus Glucose Lactate Analyzer, YSI Inc., Yellow Springs, OH, USA) and insulin (enzyme-linked immunosorbent assay (ELISA): Crystal Chem, Inc., Elk Grove Village, IL, USA) in a manner similar to that previously described [24,30]. Homeostasis model assessment (HOMA-IR) was calculated from fasting glucose and insulin values, as previously described [31].…”

Section: Methodsmentioning

confidence: 99%

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Sodium Glucose Co-Transporter 2 Inhibition Does Not Favorably Modify the Physiological Responses to Dietary Counselling in Diabetes-Free, Sedentary Overweight and Obese Adult Humans

et al. 2020

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Sedentary obesity is associated with increased risk of many cardio-metabolic diseases, including type 2 diabetes. Weight loss is therefore a desirable goal for sedentary adults with obesity. Weight loss is also a well-documented side effect of sodium glucose co-transporter 2 (SGLT2) inhibition, a pharmaceutical strategy for diabetes treatment. We hypothesized that, compared with placebo, SGLT2 inhibition as an adjunct to out-patient dietary counselling for weight loss would lead to more favorable modification of body mass and composition, and greater improvement in glucose regulation and lipid profile. Using a randomized, double-blind, repeated measures parallel design, 50 sedentary men and women (body mass index: 33.4 ± 4.7 kg/m2; mean ± SD) were assigned to 12 weeks of dietary counselling, supplemented with daily ingestion of either a placebo or SGLT2 inhibitor (dapagliflozin: up to 10 mg/day). Dietary counselling favorably modified body mass, body fat, glucose regulation, and fasting concentrations of triglyceride and very low-density lipoprotein cholesterol (main effects of counselling: p < 0.05); SGLT2 inhibition did not influence any of these adaptations (counselling × medication interactions: p > 0.05). However, SGLT2 inhibition when combined with dietary counselling led to greater loss of fat-free mass (counselling × medication interaction: p = 0.047) and attenuated the rise in high-density lipoprotein cholesterol (counselling × medication interaction: p = 0.028). In light of these data and the health implications of decreased fat-free mass, we recommend careful consideration before implementing SGLT2 inhibition as an adjunct to dietary counselling for weight loss in sedentary adults with obesity.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Sodium Glucose Co-Transporter 2 Inhibition Does Not Favorably Modify the Physiological Responses to Dietary Counselling in Diabetes-Free, Sedentary Overweight and Obese Adult Humans

et al. 2020

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“…It found that lactate levels rose more during acute exercise in the SGLT2 group when compared to the control group. The SGLT2 group saw less improvement in insulin sensitivity and a worsening of the glucose response to an oral glucose tolerance test . No studies to date have looked at the effect of exercise on ketone body formation or reduction in HbA 1c in people with type 2 diabetes on SGLT2 inhibitors.…”

Section: Interactions Between Diet Physical Activity and Drugsmentioning

confidence: 99%

“…No studies In sedentary euglycaemic overweight obese men and women less improvement in insulin sensitivity and a worsening of the glucose response to an oral glucose tolerance tests [41] No studies in patients with type 2 diabetes Acarbose Smaller fall in glucose when exercising [42] Greater fall in HbA 1c [43] DPP-4, dipetidyl peptidase-4; GLP-1, glucagon-like peptide-1; SGLT2, sodium-glucose co-transporter-2.…”

Section: Dpp-4 Inhibitors No Studies No Studies Sglt2 Inhibitorsmentioning

confidence: 99%

James Lind Alliance research priorities: should diet and exercise be used as an alternative to drugs for the management of type 2 diabetes or alongside them?

England

2020

Diabet. Med.

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Aim To review evidence on whether diet and exercise should be used as an alternative to drug therapy for the management of type 2 diabetes or alongside. Method We present a narrative review that draws on evidence from other systematic reviews and meta‐analyses, narrative reviews, trials and cohort studies. We focused mainly on glycaemic control rather than control of blood pressure or cholesterol. Results Good‐quality dietary advice that results in weight loss of >5% and physical activity interventions of >150 min/week of moderate to vigorous physical activity, combined with resistance exercise, can produce improvements in HbA1c similar to those produced by the addition of glucose‐lowering drugs. These improvements can be seen at all stages of the disease. There are recognized interactions between glucose‐lowering drugs and physical activity which may not be synergistic, but these are not well understood, and it is not clear if they are considered in clinical practice. Studies that explicitly compare drugs with diet or physical activity or control for drug use found that lifestyle could delay or reduce medication use, but most people eventually needed to progress to drug treatment. There are few studies, however, that provide strategies for the long‐term maintenance of weight loss or physical activity. Conclusion Diet and physical activity are of key importance in type 2 diabetes management, and attention to them improves glycaemic control and cardiovascular disease risk, but it is not yet known whether maintained lifestyle changes provide an alternative to drug therapy in the long term.

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Dose and time–response effect of photobiomodulation therapy on glycemic control in type 2 diabetic patients combined or not with hypoglycemic medicine: A randomized, crossover, double‐blind, sham‐controlled trial

Scontri,

de Castro Magalhães,

Damiani

et al. 2023

Journal of Biophotonics

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Photobiomodulation therapy (PBMt) combined or not with oral hypoglycemic medication has not been investigated in type 2 diabetes (T2DM) patients. All 10 T2DM patients were assessed randomly at 6 different occasions (3 with and 3 without regular oral hypoglycemic medication). Capillary glycemia was assessed after overnight fast (pre‐prandial), 1 h postprandially (standardized meal, 338 kcal), and 30 min, 3 h, 6 h, 12 h post‐PBMt (830 nm; 25 arrays of LEDs, 80 mW/array). Three doses (0 J—sham, 100 J, 240 J per site) were applied bilaterally on quadriceps femoris muscles, hamstrings, triceps surae, ventral upper arm and forearm; and randomly combined or not with oral hypoglicemic medication, totaling six different therapies applied for all 10 TDM2 patients (PBMt sham, PBMt 100 J, PBMt 240 J, PBMt sham + medication, PBMt 100 J + medication, PBMt 240 J + medication). Cardiac autonomic control was assessed by heart rate variability (HRV) indices. Without medication, there was reduction in glycemia after all PBMt doses, with 100 J as the best dose that persisted until 12 h and presented lower area under the curve (AUC). With medication, glycemia decreased similarly among doses. No differences between 100 J and sham + medication, but AUC was significantly lower after 100 J, suggesting better glycemic control. Low frequency component of HRV increased after sham + medication and 100 J, suggesting higher sympathetic activation. PBMt showed time– and dose–response effect to reduce glycemia in T2DM patients. Effects on HRV were consistent with glycemic control.

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Influence of Sodium Glucose Cotransporter 2 Inhibition on Physiological Adaptation to Endurance Exercise Training

Cited by 32 publications

References 67 publications

Sodium Glucose Co-Transporter 2 Inhibition Does Not Favorably Modify the Physiological Responses to Dietary Counselling in Diabetes-Free, Sedentary Overweight and Obese Adult Humans

Sodium Glucose Co-Transporter 2 Inhibition Does Not Favorably Modify the Physiological Responses to Dietary Counselling in Diabetes-Free, Sedentary Overweight and Obese Adult Humans

James Lind Alliance research priorities: should diet and exercise be used as an alternative to drugs for the management of type 2 diabetes or alongside them?

Dose and time–response effect of photobiomodulation therapy on glycemic control in type 2 diabetic patients combined or not with hypoglycemic medicine: A randomized, crossover, double‐blind, sham‐controlled trial

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