There are two types of diabetes: diabetes insipidus and diabetes mellitus. In diabetes insipidus, there is a deficiency of vasopressin. This hormone, also known as the anti-diuretic hormone, is produced by the hypothalamus. And, one of its functions is to concentrate urine. So, its deficiency will make the kidney unable to concentrate urine. Thus, leading to polyuria and polydipsia.
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The other type of diabetes is diabetes mellitus. It is more common than diabetes insipidus. This disease is insulin-related and has many types. Two among them are more common, type 1 and type 2 diabetes. Other types of diabetes mellitus include gestational DM, latent autoimmune diabetes in adults, and maturity-onset diabetes in the young.
In type 1 diabetes, there is absolute insulin deficiency. This is due to the body’s destruction of its cells, the beta cells of the pancreas, which produce insulin. Hence, it is an autoimmune condition and can coexist with other autoimmune diseases like vitiligo and thyroiditis.
This type of diabetes usually occurs in young people. The patients may experience weight loss, polyuria, polydipsia, and polyphagia. One of the major complications of this diabetes is diabetic ketoacidosis. In the management of this diabetes, the patient is usually placed on insulin for life.
Type 2 diabetes differs a bit from type one in that insulin is produced but there is insulin resistance among the cells. Insulin deficiency is relative, and it runs more in families than in type 1. It occurs more in older persons, and some of the patients are obese.
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One of the acute complications of type 2 diabetes is a hyperglycemic hyperosmolar state where the blood glucose is very high with little or no ketone bodies. The chronic complications of diabetes may be microvascular or macrovascular. The microvascular complications can lead to retinopathy, nephropathy, and neuropathy, including diabetic foot ulcers. While macrovascular complications can cause stroke, ischemic heart disease, and claudication.
The treatment of type 2 diabetes is usually with oral hypoglycemic drugs which are made up of many groups of drugs. They include biguanides, sulfonylureas, meglitinides, and gliflozins, among others. The gliflozins help to reduce blood glucose by inhibiting sodium-glucose co-transporter 2 in the kidney’s proximal convoluted tubules. This prevents the reabsorption of glucose by the kidney. Thus, the level of blood glucose is reduced.
The additional function of empagliflozin
Research that was done at the University of Missouri, School of Medicine, has shown that empagliflozin, an SGLUT-2 inhibitor, has another benefit apart from lowering blood glucose. The research team confirmed the fact that aging adversely affects the function of the vascular system. This conclusion was made after a study was done comparing vascular function in 18 healthy young adults, within 25 years of age, and 18 patients around 61 years. The aorta of the older adults was stiffer and the function of their endothelium impaired when compared to the young adults.
In a bid to solve this problem of decreased vascular efficiency with aging, they fed 29 male mice with an empagliflozin-enriched diet. Another group of 29 male mice was just fed with standard food not containing empagliflozin. All the mice were 72 weeks old, and they were fed for 6 weeks.
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The mice that received empagliflozin had their blood vessel function improved and the stiffness of their arteries lesser than that of the other mice group. However, there is a need for further research in line with this finding and even clinical trials.
Although diabetes mellitus is an endocrine disorder, with early diagnosis and adequate compliance to treatment, patients can live normal lives.
Empagliflozin, an SGLUT-2 inhibitor has proven to be beneficial, not only in the management of diabetes in humans but, in the improvement of vascular function in the mice. If clinical trials offer similar results, the quality of life in old age will be improved. Thus, empagliflozin is a gold mine that needs to be explored.
Empagliflozin is a drug that helps in lowering blood glucose levels. However, this study has shown an additional benefit linked to this drug. This finding is invaluable as it can be the solution to the cardiovascular disorders experienced by the aged. The need for further research cannot be overemphasized.
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SGLT2 inhibition attenuates arterial dysfunction and decreases vascular F-actin content and expression of proteins associated with oxidative stress in aged mice