Review Article
Volume 9 Issue 2 - 2022
Evening Administration of Sglt2 Inhibitors May Be More Efficacious in Preventing Night time Hyperglycemic Variability

Ram B Singh1, Ghizal Fatima2*, Osama Elmarghi3 and Gushchina Yulia4

1Halberg Hospital and Research Institute, Moradabad, India
2Era’s Lucknow Medical College and Hospital, Era University, Lucknow, India
3Naeem Diabetic Centre, Jahraa, Kuwait
4Peoples Friendship University of Russia, Moscow, Russia

*Corresponding Author: Ghizal Fatima, Era’s Lucknow Medical College and Hospital, Era University, Lucknow, India.
Received: March 26, 2022; Published: March 28, 2022




Abstract

The rotation of the earth it-self is responsible for day and night rhythms of biomarkers that are important in the physiology and metabolic functions in health and disease. A therapeutic agent may be highly bioavailable but may not be bioactive due to alterations in day and night metabolic rhythms and chrono-pharmacokinetics of the agent. A landmark experiment reported the structure and mechanism of action of the sodium glucose transporters (SGLT) proteins in relation to longevity. This evidence is of high significance because SGLT2 inhibiters are highly effective in the treatment of diabetes mellitus (DM) and cardiovascular diseases (CVDs). Glucose may be absent in the urine due to reabsorption of filtered glucose, in the kidney tubules via SGLT proteins, and metabolized by increased nighttime release of insulin. SGLT1 mRNA level is maximum at dark and hepatocyte nuclear factor-1 beta binding exhibits the circadian periodicity of SGLT1 proteins, whereas MAP 17 activates SGLT-2 in the dark. The mRNA transcription for ribosomal proteins for SGLT and ribosomal loading occur at night. In a recent study, the effects of chronotherapy with a SGLT2 inhibitor empagliflozin (EMPA) was examined, in 23 patients with type 2 DM. Treatment with EMPA in the evening or morning showed significant decline in nightly blood glucose, fasting and post prandial blood glucose, HbA1C and blood pressure in both groups. However, therapy with EMPA in the evening resulted in greater reductions in all these markers, compared to morning administration. The results indicate that night time administration of SGLT2 inhibitors may be more efficacious.

 

Keywords: Sodium Glucose Transporters; Diabetes Mellitus; Glucose; Day; Night

References

  1. Rhoads DB., et al. “Circadian periodicity of intestinal Na+/Glucose cotransporter 1 mRNA level is transcriptionally regulated”. Journal of Biological Chemistry16 (1998): 9510-9516.
  2. Yamauchi H., et al. “Regulation of the circadian rhythmic expression of SGLT1 in the mouse small intestine through histone acetylation and the mRNA elongation factor, BRD4-P-TEFb”. Bioscience, Biotechnology, and Biochemistry7 (2018): 1176-1179.
  3. Han L., et al. “Structure and mechanism of the SGLT family of glucose transporters”. Nature 601 (2021): 274-279.
  4. Tentolouris A., et al. “SGLT2 inhibitors: a review of their antidiabetic and cardioprotective effects”. International Journal of Environmental Research and Public Health16 (2019): 2965.
  5. Bertrand L., et al. “Glucose transporters in cardiovascular system in health and disease”. Pflügers Archiv - European Journal of Physiology9 (2020).
  6. Turk E., et al. “Glucose galactose malabsorption caused by a defect in the Na+/glucose cotransporter”. Nature 350 (1991): 354-356.
  7. Canul-Tec JC., et al. “Structure and allosteric inhibition of excitatory amino acid transporter 1”. Nature 544 (2017): 446-451.
  8. Takeshige Y., et al. “A sodium-glucose co-transporter 2 inhibitor empagliflozin prevents abnormality of circadian rhythm of blood pressure in salt-treated obese rats”. Hypertension Research 39 (2016): 415-422.
  9. Tentolouris A., et al. “SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects”. International Journal of Environmental Research and Public Health16 (2019): 2965.
  10. Singh RB., et al. “The evolution of rhythmicity of SGLT proteins, and uric acid in the night, and the heart. a view point”. World Heart Journal (2022): 14.
  11. Chilton R., et al. “Impact of empagliflozin on blood pressure in dipper and non-dipper patients with type 2 diabetes mellitus and hypertension”. Diabetes, Obesity and Metabolism 19 (2017): 1620-1624.
  12. Halberg F., et al. “Timing nutriceuticals”. World Heart Journal 2 (2010): 100-111.
  13. Ayyar VS and Sukumaran S. “Circadian rhythms: influence on physiology, pharmacology, and therapeutic interventions”. Journal of Pharmacokinetics and Pharmacodynamics 48 (2021): 321-338.
  14. Singh RB., et al. “Effect of chronotherapy with empagliflozin, among patients with type 2 diabetes mellitus. a nonrandomized, single blind observation”. Advances in Therapy (2021).
  15. Yoshida Y., et al. “Alteration in circadian machinery of monocytes underlies chronic kidney disease associated cardiac inflammation and fibrosis”. Nature Communications1 (2021): 2783.
  16. Xu J., et al. “Effects of SGLT2 Inhibitors on Atherosclerosis: Lessons from Cardiovascular Clinical Outcomes in Type 2 Diabetic Patients and Basic Researches”. Clinical Medicine1 (2022): 137.
  17. Benarroch BE. “Brainstem integration of arousal, sleep, cardiovascular, and respiratory control”. Neurology21 (2018): 958-966.
  18. Brown RE., et al. “Control of sleep and wakefulness”. Physiological Reviews3 (2012): 1087-187.
  19. Rodríguez-Cortés B., et al. “Suprachiasmatic nucleus-mediated glucose entry into the arcuate nucleus determines the daily rhythm in blood glycemia”. Current Biology (2022).
  20. Fagard RH., et al. “Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension”. Hypertension 51 (2008): 55-61.
Citation: Ghizal Fatima., et al. “Evening Administration of Sglt2 Inhibitors May Be More Efficacious in Preventing Night time Hyperglycemic Variability”. EC Gynaecology 9.2 (2022): 06-10.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.