These impacts of SGLT2 inhibitors may lead to improvements in endothelial function. SGLT2 inhibitors induce diuresis and glycosuria to decrease the intravascular volume and lower the cardiac preload and afterload, which consequently increase the cardiac output. showed that changes in hematocrit and hemoglobin levels in the EMPA-REG OUTCOME trial might be major mediators of empagliflozin-induced decreases in the incidence of cardiovascular events. Some meta-analyses and large clinical trials have shown that SGLT2 inhibitors reduce cardiovascular events in patients with type 2 diabetes and reduced the rate of hospitalization for heart failure in patients with heart failure. Sodium glucose cotransporter 2 (SGLT2) inhibitors are oral glucose medicines that lower glucose levels by reducing the renal reabsorption of glucose. Registration Number for Clinical Trial: jRCT1071220089 ( ). Over a 24-month period, the addition of ipragliflozin to standard therapy in patients with type 2 diabetes did not change endothelial function assessed by FMD in the brachial artery. There was no significant difference in the estimated percentage change in FMD between the two groups (P = 0.77). There was no significant difference between FMD values at baseline and after 24 months in both groups (5.2 ± 2.6% vs. However, there was no significant difference between the changes in HbA1c levels in the two groups (7.4 ± 0.8% vs. HbA1c levels significantly decreased after 24 months of treatment compared to the baseline value in the ipragliflozin group, but not in the control group. Among the 482 patients in the PROTECT study, flow-mediated vasodilation (FMD) was assessed in 32 patients in the control group and 26 patients in the ipragliflozin group before and after 24 months of treatment. In the PROTECT study, patients were randomized to receive either standard antihyperglycemic treatment (control group, n = 241 ) or add-on ipragliflozin treatment (ipragliflozin group, n = 241) in a 1:1 ratio. We assessed the impact of 24 months of treatment with ipragliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, on endothelial function in patients with type 2 diabetes as a sub-analysis of the PROTECT study.
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