Sodium-Glucose Cotransporter 2 Inhibitors May Prevent Type 2 Diabetes in High Risk Individuals

The commonly accepted definition of prediabetes is as follows: prediabetes is when a person has abnormally high blood glucose, but the blood glucose is not high enough to be called diabetes. Over 96 million adult Americans have prediabetes and most of them don't know they have the condition. And for those persons with prediabetes who also have chronic kidney disease or heart failure, one study, which was a meta-analysis, indicates that Sodium-Glucose Cotransporter 2  or SGLT2 inhibitors can be helpful in lowering the risk of progression from prediabetes to type 2 diabetes. 

SGLT2 inhibitors are an FDA-approved family of prescription medications that are used in conjunction with diet and exercise to reduce blood sugar levels in persons with type 2 diabetes. "Medicines in the SGLT2 inhibitor class include canagliflozin, dapagliflozin, and empagliflozin. They are offered as both single-ingredient formulations and in combinations with other diabetes medications, such as metformin." SGLT2 inhibitors reduce blood sugar by stimulating the kidneys to excrete sugar through urine.

The meta-analysis, mentioned above, was performed by searching randomized controlled trials (RTCs) in the Medline and Embase databases. The study's objective was to determine if SGLT2 inhibitors lowered the risk of diabetes in individuals with prediabetes. The study consisted of 5655 participants with prediabetes. The database searchers were completed on February 11, 2022.

After comparing individuals with prediabetes who used SGLT2 inhibitors with a control group, the researchers concluded that SGLT2 inhibitors lowered the risk of diabetes. In fact, the researchers indicated that SGLT2 inhibitors lowered the risk of type2 diabetes for "adults with prediabetes and heart failure or chronic kidney disease."

Since type 2 diabetes is a serious condition which is continuing to be more prevalent, healthcare providers should use all tools in their arsenals to lower the risk of the disease progressing from prediabetes to diabetes. Lifestyle medicine methods are often used to treat prediabetes to delay or prevent type 2 diabetes. Perhaps, for those patients with prediabetes and heart failure or chronic kidney disease, SGLT2 inhibitors may be worth considering.

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Changing DASH Diet Components Can Improve the Diet

The DASH diet, or the Dietary Approach to Stop Hypertension, is a diet aimed at treating high blood pressure. And in general, the diet is considered to be a healthy pattern of eating that can lower blood pressure. One study suggests that using plant-based protein instead of animal-based protein in the diet can improve the effectiveness of the diet.

The DASH diet puts a special focus on eating fruits, vegetables and whole grains. The diet also emphasizes protein from fish, poultry and nuts. These foods are high in calcium, protein, potassium and fiber, and the nutrients can help lower blood pressure. Further, after looking at the top diets in use in 2022, the U.S.News rated the DASH diet as the second best overall diet. The U.S.News indicated that the diet puts limitations on saturated fats and salt. And that individuals who follow the DASH diet will eventually lower their salt consumption to about 1500 mg per day.

In the DASH diet, the source of the protein is not specified. It can be plant based or animal based. The above-referenced study compared the effectiveness of animal versus plant protein in the DASH diet. In the study, which was a double-blind randomized controlled clinical trial, ninety obese patients with metabolic syndrome, aged 30-70, were randomly assigned to two DASH-diet groups.

One of the groups consumed plant protein and the other consumed animal protein. The study was an 8-week experiment. At the start and conclusion of the study, measurements of blood pressure, weight, and waist circumference (WC) were taken.

Blood pressure, fasting plasma glucose (FPG), triglyceride (TG) concentrations, weight, and WC all decreased significantly in both groups. However, after adjusting for weight change, the drop in FPG and systolic blood pressure (SBP) was greater in the plant-based-protein DASH group than in the animal-based-protein DASH group. For total cholesterol, LDL-C, and HDL-C, no significant differences were detected among or between groups.

The DASH diet has a reputation for being a healthy diet. Indeed, it has been shown to effectively treat hypertension. The diet can help a person achieve improvements in cardiometabolic measurements. But placing more emphasis on plant-based rather than animal-based protein, in the diet, might be a good way to improve what is already a good diet.

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