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


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


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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.

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