i don't what to say really. the amount of work u put into your videos and content and the knowledge in such a short amount of time , it amazes me. honestly THANK YOU so much for your amazing efforts :'(
It certainly is an easy-to-understand video. I appreciate your hard work and effort in making such a great video:) It improved my understanding of SGLT-2 inhibitors.
It's really helpful. I am not a medical/pharmacology or related subjects student but it seem I have understand all the points that you have mentioned in the video.
I was prescribed Dapagliflozin along with several other medications to treat heart failure with reduced ejection fraction (25% to 35%). The combination of drugs I take really has had a very marked improvement in my health. I am 78, male. I have been Type II diabetic for over 10 years, but it was diet controlled throughout. I never needed any medication. I was declared to be in remission about three years ago. I also strove to lose a lot of weight by accurately counting calories of everything I consumed. My weight went from 82kg to currently 64kg in ten years. I am 1.56m tall.
You can reduce your glucose in the blood by a very low carbohydrate diet and by reducing your insulin resistance with intermittent fasting. Then you don’t need this drug because the blood sugar in your blood is less.
I agree with the A1c high and keto. I been in keto for 2 yrs and I am into a week with sglt2 and what a difference today my fasting reading was 124, did not see that in the past 15 years +. The only side effect is the uring smels very strong . Taking only 1 /2 pill 5mg daily.
Terminology for Ketoacidosis with SGLT 2 inhibitor is euglycaemic ketoacidosis. BSL is normal but still there is ketosis related to excessive glucose excretion triggering starvation pathway.
I have not read into this, however I wonder if it is because the low glucose levels caused by glucose loss in the urine results in less insulin being produced by the pancreas. (Insulin is released in response to high blood glucose levels). Without insulin, cells cannot recognise and take in glucose so ketones are produced. The patient does not become hyperglycaemic due to the SGLT2 inhibitors causing glucose loss in the urine, so they have a normoglycaemic ketoacidosis. Correct me if I am wrong.
You are right, once blood glucose level gets above a certain threshold then glucose is excreted in the urine, however SGLT2 still acts to cause reabsorption of some of a proportion of that glucose, so adding an SGLT2 inhibitor can still be helpful in increasing the glucose excretion in the urine.
Normal Renal threshold for sugar is 180 mg . More than this is excreted.... in diabeticsof long duration renal threshold goes up for sugar excretion. That means even when there is Hyperglycaemia Urine test will show no sugar .... Does it play any part in dKA.
Thanks for this amazing video can I ask I didn't understand the side effects clearly bcoz I read that sglt2 has benefits such as weight loss, reduction in blood pressure
When glucose is excreted through urine, how come there's still a chance to have diabetic ketoacidosis in our body? I'm aware the diabetic ketoacidosis is excess of glucose level in body but still don't quite understand about this part
I think the answer to your question is that there is only so much glucose that the kidneys will excrete. DKA is also related to the cells in the body not being able to recognise glucose due to the lack of insulin, not only the excess glucose level. I have a video on diabetic ketoacidosis - it is a bit old and not as slick but may still be helpful and I think it will help understand how this happens.
Now these are used for heart failure. Can you explain why this works for this subset of patients whose condition has nothing to do with sugar metabolism.
The research says there is a decline in kidney function but not too severe and overall they protect the kidneys. This is why you dont give SGLT2i to people with low GFR.
Seen nuber of videos on the subject. In one of them dont remember it was saying (the tube system shown ) a certain part of it goes weak.perhaps while explaining side effects.which is not repairable is true . Anyone who have knowledge abot it share it with patients.thanks
The convention antidiabetic drugs positively lower sugar without compromising the immunity by positively maintaining energy to the cells whereas sglt2 inhibitors negatively effect immunity of the body by excreting energy by excreting glucose in the urine which gains significance during covid as has happened to my brother Simon who was quarantined noting his normal sugar level and general health and he landed with irreversible Ards and death. Please consider this aspect before promoting this drug during this pandemic
Hi. Isn’t it true that SGLT2 is overly expressed in diabetics - meaning that a higher glucose concentration is needed (~ 13.5 mmol) before it is excreted in the urine, as opposed to the 10 mmol in ‘normals’. And that SGLT2 inhibitors reduced the level (above which glucose excretion begins) to ~ 5.6 mmol ?
Hi Peter. Thats very interesting. I have a very quick look at the literature and I couldn't find anything on this so I'm not sure. I'll keep it in mind. Thanks for the comment.
Water will tend to follow sodium along the osmotic gradient, so water will be excreted along with sodium and the sodium in the blood will not be diluted. hope that makes sense
I couldn't see hyponatraemia listed as a side effect in the BNF. Water is drawn out by osmotic diuresis along with the glucose and sodium, so the concentration of sodium does not decrease. Good question!
@@ZeroToFinals can you elaborate further?? Osmotic diuresis is inhibition of reabsorption of water and sodium. So it should cause hyponatremia.. may be dka is due to dehydration contributed by osmotic diuresis
@@gold5335 Have a look at my video on hyponatraemia, which may be helpful. As the sodium is pumped out into the urine, water will follow it due to osmosis (water will move to the area of higher concentration of sodium and balance the sodium) and therefore maintain a normal concentration of sodium in the blood.
i don't what to say really. the amount of work u put into your videos and content and the knowledge in such a short amount of time , it amazes me. honestly THANK YOU so much for your amazing efforts :'(
It certainly is an easy-to-understand video. I appreciate your hard work and effort in making such a great video:) It improved my understanding of SGLT-2 inhibitors.
In this conversation I totally grab the knowledge about dapagliflozin molecules.Thank you so much.
Thankyou so much for putting in so much efforts to make us understand the concepts so easily. I totally get the topic now :)
It's really helpful. I am not a medical/pharmacology or related subjects student but it seem I have understand all the points that you have mentioned in the video.
Thats great to hear. I like to make things as simple as possible so anyone can understand
Its very simple and easy to learn and understandable.....Thank you Now i clearly understand
Just what I was looking for! Thank you for doing this work of putting this video together.
Awesome! So glad to help
Thank you very much Doctor for the Useful medical Information 🎉👍🎉
Thank you so much for this video. It really helped me solidify my knowledge about SGLT-2 inhibitors.
Hi, great video. Would it be possible for you to explain why dapaglifloxin has now been indicated for use in heart failure patients. Thank you
because it prevents further stiffening of heart muscle due to sugary blood and also has diuretic function.
I was prescribed Dapagliflozin along with several other medications to treat heart failure with reduced ejection fraction (25% to 35%). The combination of drugs I take really has had a very marked improvement in my health. I am 78, male. I have been Type II diabetic for over 10 years, but it was diet controlled throughout. I never needed any medication. I was declared to be in remission about three years ago. I also strove to lose a lot of weight by accurately counting calories of everything I consumed. My weight went from 82kg to currently 64kg in ten years. I am 1.56m tall.
I have atrial fibrillation that is starting to damage the heart. Just been put on Dapa for it and lost lots of weather combined with a diuretic
Your explanation is so good that I see your video on x2 and I wish there is x3 and still understand everything 😍
That's great! Thanks!
Hallo.I like this video because it explains simply and clearly explains the mechanism of action of SGLT2 inhibitors.
Good job. Using this to study for my commonly used drugs test in pharmacy school
So easy to understand its actions after seeing your video 🤩
You can reduce your glucose in the blood by a very low carbohydrate diet and by reducing your insulin resistance with intermittent fasting. Then you don’t need this drug because the blood sugar in your blood is less.
Have been keto for 8 yr and less than20 grams per day. But still my A1C is 9. Early on it was 6.2 my lowest ever. Trying SGLT2.
I agree with the A1c high and keto. I been in keto for 2 yrs and I am into a week with sglt2 and what a difference today my fasting reading was 124, did not see that in the past 15 years +. The only side effect is the uring smels very strong . Taking only 1 /2 pill 5mg daily.
Terminology for Ketoacidosis with SGLT 2 inhibitor is euglycaemic ketoacidosis. BSL is normal but still there is ketosis related to excessive glucose excretion triggering starvation pathway.
New indication now for Dapagliflozin for HFrEF patients (leftsided heart insufficiency with EF ≤40%). :)
and HFpEF
Not a student, however very informative. Thank you just received a suggestion from my doctor.
Thank you for this amazing explanation
Thank you very much. It was so easy to understand.
Beautifully explained , thanks a ton for sharing video sir
Thanks for the clear content!
Glad to help
Simply superb 👍
Thank you so much for crystal-clear concept.....
Glad to help!
Very nice illustration sir
Need to update the video
About benefits with CKD & Heart Failure with reduction of all cause Mortality
Phimosis may also be one of the side effects of Jardiance and other SGLT2i in uncircumcised men. Please add that to your video in future.
GREAT, DO "YOU" FEEL FARXIGA WILL ! KEEP THE KIDNEYS WORKING AT GOOD LEVELS "LONGER" TO KEEP US ALIVE
PS GREAT JOB, THANKS
Excellent...👍👍
Thank you so much for this video. Very clearly.
Thank you very much for the very clear explanation :)
Thank you
Very Helpful. Thank you!
That was very helpful. Thank you!
Dapa is now FDA indicated for Heart Failure and Type 2 DM
Empagliflozin too. In fact by preventing or stopping stiffening of heart muscle they are very useful medicines for stoppping diabetic cardiomyopathy.
Thankyou so so so much! This was very helpful
for your analytics - thank you
Thank you for information. Much needed info.
Glad to help!
Thanks 🙏🏻
Been given for heart thanks
Thank you very much for this video
Good stuff
great sir. thank you so much for making it so easy..
Beautiful video.
very well done !
You are smart 😊
Impressive and informative video
Excellent content...thank you
Thanks for this videos
thank you! so much easier
Very nice ..
Thanks alot
Hi, I am just wondering if you could explain how they cause Diabetic ketoacidosis. Thank you for sharing
I have not read into this, however I wonder if it is because the low glucose levels caused by glucose loss in the urine results in less insulin being produced by the pancreas. (Insulin is released in response to high blood glucose levels). Without insulin, cells cannot recognise and take in glucose so ketones are produced. The patient does not become hyperglycaemic due to the SGLT2 inhibitors causing glucose loss in the urine, so they have a normoglycaemic ketoacidosis. Correct me if I am wrong.
Thank you very much for great video!
Glad you found it!
Very informative thanks for sharing.
very clear
thanks
Excellent
The glucose in diapetic patient is excrete from kidny naturally without need for SGLT2 inhibitors.
You are right, once blood glucose level gets above a certain threshold then glucose is excreted in the urine, however SGLT2 still acts to cause reabsorption of some of a proportion of that glucose, so adding an SGLT2 inhibitor can still be helpful in increasing the glucose excretion in the urine.
Normal Renal threshold for sugar is 180 mg . More than this is excreted....
in diabeticsof long duration renal threshold goes up for sugar excretion. That means even when there is Hyperglycaemia Urine test will show no sugar ....
Does it play any part in dKA.
very helpful sir thank you..!
Thank you 🤩
Excellent video! but how does it help non-diabetic patients with CKD (Iga Nephropathy? Thank you.
Thanks for this amazing video can I ask I didn't understand the side effects clearly bcoz I read that sglt2 has benefits such as weight loss, reduction in blood pressure
More on side effects please -'Monilial infections?
Great video. But why does serum creatinine, and urine protein and albumin increase while taking Farxiga?
Thank you. It's great
Glad to help
Excellent thanks!
No problem. glad to help!
Is there also a chance of secreting sodium while taking SGLT-2 inhibitors? Or maybe even going to the extreme of causing hyponatremia?
When glucose is excreted through urine, how come there's still a chance to have diabetic ketoacidosis in our body? I'm aware the diabetic ketoacidosis is excess of glucose level in body but still don't quite understand about this part
I think the answer to your question is that there is only so much glucose that the kidneys will excrete. DKA is also related to the cells in the body not being able to recognise glucose due to the lack of insulin, not only the excess glucose level. I have a video on diabetic ketoacidosis - it is a bit old and not as slick but may still be helpful and I think it will help understand how this happens.
@@ZeroToFinals thank you! I'll check it out!
Thankyou!!!
Awesome ❤
Love you ❤️
thanks !
Is it possible to take SLGT2 inhibitor with ACE inhibitor?
Wonderful
Thanx a lot
Now these are used for heart failure. Can you explain why this works for this subset of patients whose condition has nothing to do with sugar metabolism.
Great..... Super....
Perfect thank you soooo much
So glad I could help!
This is great thanks 👍🏻 Subscribed
Awesome! Thanks Webby that means a lot
Amazing INFORMATION thanks please Tami translation please
Kindly make SGLT2 In Hear Failure,
Does it has a bad effect on kidney if used on a long term...?
The research says there is a decline in kidney function but not too severe and overall they protect the kidneys. This is why you dont give SGLT2i to people with low GFR.
Informative
I am on Jardiamet and Ozempic at the moment for Type 2. So if my mmol/L is
Really helpful, thank you so much!!!
Glad you liked it!
Seen nuber of videos on the subject. In one of them dont remember it was saying (the tube system shown ) a certain part of it goes weak.perhaps while explaining side effects.which is not repairable is true . Anyone who have knowledge abot it share it with patients.thanks
Soo cool videos👍
Good
Statistical analysis of covid deaths with diabetics on sglt2 inhibitors will provide the answer
I had horrendous urine infection after taking only 3 dapagliflozin
If Any chance of hypoglycemia
I've been prescribed this for heart failure 🤔
The convention antidiabetic drugs positively lower sugar without compromising the immunity by positively maintaining energy to the cells whereas sglt2 inhibitors negatively effect immunity of the body by excreting energy by excreting glucose in the urine which gains significance during covid as has happened to my brother Simon who was quarantined noting his normal sugar level and general health and he landed with irreversible Ards and death. Please consider this aspect before promoting this drug during this pandemic
👍
Any Gliflozines are safe for ckd patient and what are tha contraindications for tha T2dm patients
Can dapa help reduce inflamation markers?
Hi. Isn’t it true that SGLT2 is overly expressed in diabetics - meaning that a higher glucose concentration is needed (~ 13.5 mmol) before it is excreted in the urine, as opposed to the 10 mmol in ‘normals’. And that SGLT2 inhibitors reduced the level (above which glucose excretion begins) to ~ 5.6 mmol ?
Hi Peter. Thats very interesting. I have a very quick look at the literature and I couldn't find anything on this so I'm not sure. I'll keep it in mind. Thanks for the comment.
Hi, Tom. Many thanks for your reply. This may be of some interest then; starting at approx. 6:03: czcams.com/video/pJzGOWZc4OY/video.html
Plus this review: www.ncbi.nlm.nih.gov/pmc/articles/PMC5298360/
@@peterreid560 Thanks
i wanna use these for fat loss purpose I'm not diabetic, would this make me diabetic?
What about Natrium? If it cannot be reabsorbed, isn't there a potential problem of hyponatremia?
Water will tend to follow sodium along the osmotic gradient, so water will be excreted along with sodium and the sodium in the blood will not be diluted. hope that makes sense
@@ZeroToFinals please answer will it cause hyponatremia yes or no?
can you please share your website?
Can Sglt 2 inhibitors cause hyponatremia??
Since it blocks sodium n glucose reabsorption.
I couldn't see hyponatraemia listed as a side effect in the BNF. Water is drawn out by osmotic diuresis along with the glucose and sodium, so the concentration of sodium does not decrease. Good question!
@@ZeroToFinals can you elaborate further??
Osmotic diuresis is inhibition of reabsorption of water and sodium. So it should cause hyponatremia.. may be dka is due to dehydration contributed by osmotic diuresis
@@gold5335 Have a look at my video on hyponatraemia, which may be helpful. As the sodium is pumped out into the urine, water will follow it due to osmosis (water will move to the area of higher concentration of sodium and balance the sodium) and therefore maintain a normal concentration of sodium in the blood.
@@ZeroToFinals So does that mean it can? Yes or No? Please answer?
It does my friend, and this is one of the causes of the hypotension seen in its users, you can check this in Lippincott for pharmacology chapter 25.