The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study
<i>Background and Objectives</i>: Insulin resistance (IR) is a key factor involved in the development of type 2 diabetes (T2D). Besides its role in the pathogenesis of T2D, insulin resistance is associated with impairment of glycemic control, reduced achievement of glycemic targets, and...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/2/209 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850229955579871232 |
|---|---|
| author | Liana Iordan Sandra Lazar Romulus Timar Simona Popescu Teodora Sorescu Oana Albai Adina Braha Bogdan Timar Laura Gaita |
| author_facet | Liana Iordan Sandra Lazar Romulus Timar Simona Popescu Teodora Sorescu Oana Albai Adina Braha Bogdan Timar Laura Gaita |
| author_sort | Liana Iordan |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Insulin resistance (IR) is a key factor involved in the development of type 2 diabetes (T2D). Besides its role in the pathogenesis of T2D, insulin resistance is associated with impairment of glycemic control, reduced achievement of glycemic targets, and increases in cardiovascular risk and diabetes complications, being thus a negative prognosis factor. Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are therapies for T2D which demonstrated, besides glycemic control, improvements of biomarkers traditionally associated with IR and inflammation. This study aimed to evaluate the impact of SGLT2i treatment on IR and inflammation biomarkers in patients with T2D. <i>Materials and Methods</i>: In a retrospective study, 246 patients with T2D treated with SGLT2i for a median of 5 years were evaluated regarding IR (estimated glucose disposal rate—eGDR, triglyceride/glucose index, triglyceride/HDLc index) and inflammation biomarkers (neutrophils to lymphocyte ratio, platelets to lymphocytes ratio and C-reactive protein) before and after intervention with SGLT2i. <i>Results</i>: After a median 5 years of SGLT2i treatment, patients with T2D had a higher eGDR (6.07 vs. 5.24 mg/kg/min; <i>p</i> < 0.001), lower triglyceride/HDLc ratio (3.34 vs. 3.52, <i>p</i> < 0.001) and lower triglyceride/glucose index (9.23 vs. 9.58; <i>p</i> < 0.001). The inflammation biomarkers decreased after SGLT2i therapy: C-reactive protein (3.07 mg/L vs. 4.37 mg/L), NLR (0.68 vs. 0.72; <i>p</i> < 0.001), and PLR (115 vs. 122; <i>p</i> < 0.001). Intervention with SGLT2i also improved the biomarkers associated with diabetes complications and cardiovascular risk: HbA1c (7.1% vs. 8.4%; <i>p</i> < 0.001), body mass index (30.0 vs. 31.5 kg/m<sup>2</sup>; <i>p</i> < 0.001) and urinary albumin to creatinine ratio (4.75 vs. 11.00 mg/g; <i>p</i> < 0.001). <i>Conclusions</i>: Treatment with SGLT2i in patients with T2D leads to decreases in IR and inflammation. These mechanisms may partially explain the additional cardiovascular and renal risk reductions associated with SGLT2i therapy, alongside the improvements in glycemic control, in patients with T2D. |
| format | Article |
| id | doaj-art-cb5d7287e9cb48bd9ea367756734a281 |
| institution | OA Journals |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-cb5d7287e9cb48bd9ea367756734a2812025-08-20T02:04:01ZengMDPI AGMedicina1010-660X1648-91442025-01-0161220910.3390/medicina61020209The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective StudyLiana Iordan0Sandra Lazar1Romulus Timar2Simona Popescu3Teodora Sorescu4Oana Albai5Adina Braha6Bogdan Timar7Laura Gaita8Doctoral School of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDoctoral School of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaSecond Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania<i>Background and Objectives</i>: Insulin resistance (IR) is a key factor involved in the development of type 2 diabetes (T2D). Besides its role in the pathogenesis of T2D, insulin resistance is associated with impairment of glycemic control, reduced achievement of glycemic targets, and increases in cardiovascular risk and diabetes complications, being thus a negative prognosis factor. Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are therapies for T2D which demonstrated, besides glycemic control, improvements of biomarkers traditionally associated with IR and inflammation. This study aimed to evaluate the impact of SGLT2i treatment on IR and inflammation biomarkers in patients with T2D. <i>Materials and Methods</i>: In a retrospective study, 246 patients with T2D treated with SGLT2i for a median of 5 years were evaluated regarding IR (estimated glucose disposal rate—eGDR, triglyceride/glucose index, triglyceride/HDLc index) and inflammation biomarkers (neutrophils to lymphocyte ratio, platelets to lymphocytes ratio and C-reactive protein) before and after intervention with SGLT2i. <i>Results</i>: After a median 5 years of SGLT2i treatment, patients with T2D had a higher eGDR (6.07 vs. 5.24 mg/kg/min; <i>p</i> < 0.001), lower triglyceride/HDLc ratio (3.34 vs. 3.52, <i>p</i> < 0.001) and lower triglyceride/glucose index (9.23 vs. 9.58; <i>p</i> < 0.001). The inflammation biomarkers decreased after SGLT2i therapy: C-reactive protein (3.07 mg/L vs. 4.37 mg/L), NLR (0.68 vs. 0.72; <i>p</i> < 0.001), and PLR (115 vs. 122; <i>p</i> < 0.001). Intervention with SGLT2i also improved the biomarkers associated with diabetes complications and cardiovascular risk: HbA1c (7.1% vs. 8.4%; <i>p</i> < 0.001), body mass index (30.0 vs. 31.5 kg/m<sup>2</sup>; <i>p</i> < 0.001) and urinary albumin to creatinine ratio (4.75 vs. 11.00 mg/g; <i>p</i> < 0.001). <i>Conclusions</i>: Treatment with SGLT2i in patients with T2D leads to decreases in IR and inflammation. These mechanisms may partially explain the additional cardiovascular and renal risk reductions associated with SGLT2i therapy, alongside the improvements in glycemic control, in patients with T2D.https://www.mdpi.com/1648-9144/61/2/209insulin resistanceinflammationsodium-glucose co-transporter 2 inhibitorsestimated glucose disposal rate |
| spellingShingle | Liana Iordan Sandra Lazar Romulus Timar Simona Popescu Teodora Sorescu Oana Albai Adina Braha Bogdan Timar Laura Gaita The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study Medicina insulin resistance inflammation sodium-glucose co-transporter 2 inhibitors estimated glucose disposal rate |
| title | The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study |
| title_full | The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study |
| title_fullStr | The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study |
| title_full_unstemmed | The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study |
| title_short | The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study |
| title_sort | impact of sodium glucose co transporter 2 inhibition on insulin resistance and inflammation in patients with type 2 diabetes a retrospective study |
| topic | insulin resistance inflammation sodium-glucose co-transporter 2 inhibitors estimated glucose disposal rate |
| url | https://www.mdpi.com/1648-9144/61/2/209 |
| work_keys_str_mv | AT lianaiordan theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT sandralazar theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT romulustimar theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT simonapopescu theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT teodorasorescu theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT oanaalbai theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT adinabraha theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT bogdantimar theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT lauragaita theimpactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT lianaiordan impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT sandralazar impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT romulustimar impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT simonapopescu impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT teodorasorescu impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT oanaalbai impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT adinabraha impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT bogdantimar impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy AT lauragaita impactofsodiumglucosecotransporter2inhibitiononinsulinresistanceandinflammationinpatientswithtype2diabetesaretrospectivestudy |