Thread by @iamnephrologist

🔆Decision Algorithm for prescribing #SGLT2i #GLP1RA in #DKD

Ref-CJASN
doi: 10.2215/CJN.02690320
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🔆Strategies to ⬇️adverse events in #SGLT2i #GLP1RA

💡Keep genitals dry & clean
💡Prophylactic topical antifungal
💡⬇️Diuretic dose
💡Pt education-"STOP DKA" Protocol
💡Self foot examination
💡Monitor PTH/VitD

doi: 10.2215/CJN.02690320
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🔆Trials #SGLT2i #GLP1RA

Ref-CJASN
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🔆Adverse events (vs Placebo) reported with different #SGLT2i

Ref-Expert Opinion on Drug Safety
doi: 10.1080/14740338.2020.1733967
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🔆Efficacy of different #SGLT2i

Ref-Expert Opinion on Drug Safety
doi: 10.1080/14740338.2020.1733967
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🔆SGLT 1/2 Selectivity of different #SGLT2i

Ref-Diseases
doi: 10.3390/diseases8020014
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🔆Extraglycemic effects and Mechanisms: #SGLT2i

Ref-Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
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🌸#SGLT2i and Phosphate Homeostasis

Ref-Diabetes & Metabolic Syndrome: Clinical Research & Reviews
doi: 10.1016/j.dsx.2017.08.003
#NephroNotes #Nephpearls #FOAMed #MedTwitter #MedEd

🌸#SGLT2i and Potassium Homeostasis

💡Like ACEI/ARB, SGLT2i ⬆️Potassium but to lower extent

Ref-Diabetes & Metabolic Syndrome: Clinical Research & Reviews
doi: 10.1016/j.dsx.2017.08.003
#NephroNotes #Nephpearls #FOAMed #MedTwitter #MedEd

🌸#SGLT2i and Magnesium Homeostasis

Ref-Diabetes & Metabolic Syndrome: Clinical Research & Reviews
doi: 10.1016/j.dsx.2017.08.003
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🌸#SGLT2i ⬆️Sodium in patients with SIADH

👉4 days of Empagliflozin significantly ⬆️ Sodium c/f placebo
👉Profound HypoNa (125 mmol/L) & lower baseline osmolality⬆️ likelihood of response

Ref-JASN
doi: 10.1681/ASN.2019090944
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🌸#SGLT2i Mechanism of increased Erythropoietin production

Ref-Circulation
doi: 10.1161/CIRCULATIONAHA.118.038881
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🌸 #SGLT2i and Bone Metabolism

Ref-Frontiers in Pharmacology
doi: 10.3389/fphar.2018.01517
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🌸 #SGLT2i & Neuropathy

🔥Topic less explored‼️
☄Beneficial in Diabetic peripheral neuropathy
👉Significant⬇️in hypersensitivity response
👉PGP9.5 immunoreactive small nerve loss significantly prevented

Ref-DMJ
doi:10.4093/dmj.2017.0095
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🌸 #SGLT2i Potential Therapeutic Option in Diabetic Retinopathy‼️

👉Need to explore‼️

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🌸 #SGLT2i & Atrial Fibrillation/Flutter in T2DM

☄Dapagliflozin⬇️risk of both 1st & total number of episodes of AF/AFL in T2DM irrespective of prevalence
of AF/ASCVD/HF

Ref-Circulation
doi:10.1161/CIRCULATIONAHA.119.044183
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🌸 #SGLT2i and Obesity

☄Empagliflozin ⬇️obesity-
👉⬆️Energy expenditure
👉Adipose tissue browning
👉⬇️Obesity ass inflammation
👉⬇️Insulin resistance
(Alternative macrophage activation)

Ref-BMJ
doi: 10.1136/bmjdrc-2019-000783
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🔥 #SGLT2i & Genital Infections

Ref-Int J Diab
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🌸 #SGLT2i & Postransplant Diabetes

Ref-Nature Reviews
doi: 10.1038/s41581-019-0173-0
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🌸 #SGLT2i & NAFLD/NASH in Diabetes

Ref- Diabetes & Metabolism
doi: 10.1016/j.diabet.2019.01.008
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