Although the protectors of SGLT-2 are at the heart of the treatment of diabetes, their exact mechanism of action has not yet been known. In a study conducted by a research group led by Peter Wolf, Martin Krssak and Michael Krebs of MedUni Vienna’s Department of Medicine III, a magnetic resonance spectroscope (MRS) was used to show a direct link between glucose elimination through the kidneys. and new glucose production in the liver.
A single dose of the SGLT-2 inhibitor dapagliflozin induces a beneficial regulatory mechanism, in which glucose loss due to drug-induced SGLT-2 inhibition is directly offset by a corresponding increase in glucose production. new in the liver. The study was published in the leading journal Diabetes Care.
Dapagliflozin is a drug from the group of SGLT-2 inhibitors, which is routinely used in the treatment of diabetes. They increase the amount of glucose in the urine. This lowers blood glucose levels and patients also lose weight. Beneficial effects on fatty liver, which is common among diabetics, after a twelve-week course of the drug are also reported. Surprisingly, this group of drugs appears to have a protective effect on the heart and kidneys. However, the acute effect on lipid and energy metabolism has not yet been studied.
A research group led by Peter Wolf, Martin Krssak and Michael Krebs from the Department of Endocrinology and Metabolism at the Department of Medicine III has now conducted a study using MRS, in which they observed six diabetic patients and a control group of ten healthy volunteers after they had taken dapagliflozin.
It was found that, in the short term, the level of excess glucose excreted in the liver was commensurate with what was lost in the urine as a result of the action of the drug. This suggests that immediate elimination of excess glucose through the kidneys stimulates a series of regulatory mechanisms that affect metabolism in several organs and thus may play a role in beneficial effects. this drug.
The study was carried out in collaboration with the Center of Excellence for Advanced MRI of MedUni Vienna’s Department of Biomedical Imaging and Imaging-led Medicine. Using high-resolution magnetic resonance imaging, it was possible to make a linear measurement of glucose and fat storage in the liver in a noninvasive manner.
In conjunction with the detection of detectors (such as a marked glucose solution, for example) it is possible to use this “significant biopsy” to identify changes in glucose and lipid metabolism in vivo and to study the acute effect. , short-term. of drugs.
Source:
Vienna Medical University
Magazine Reference:
Wolf, P., et al. (2021) Gluconeogenesis, But not Glycogenolysis, contributes to the increase in endogenous glucose production by inhibition of SGLT-2. Diabetes Care. doi.org/10.2337/dc20-1983.