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Версія від 13:35, 26 листопада 2016, створена Camel2park (обговореннявнесок) (Створена сторінка: 28 Empagliflozin was well tolerated; however, each CKD group had small decreases in eGFR, which returned to baseline levels after the end of treatment (during a...)

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28 Empagliflozin was well tolerated; however, each CKD group had small decreases in eGFR, which returned to baseline levels after the end of treatment (during a 3-week follow-up period).28 Hypoglycemia Where glucose lowering is needed without risking hypoglycemia, SGLT2 inhibitors have greater glucose-reducing effects than DPP-4 inhibitors when considering a second-line add-on to metformin.50 They can also be used in combination with DPP-4 inhibitors, if a three-drug combination is required.26 Similarly, a combination of metformin, pioglitazone, and check details an SGLT2 inhibitor would not be expected to increase the risk of hypoglycemia.21 For patients receiving insulin secretagogues (eg, sulfonylureas) or insulin, a dose reduction should be considered when adding empagliflozin to reduce hypoglycemia risk.6 In my experience, this is especially important for patients whose HbA1c levels are closer to target. Hypertension The majority of patients with T2DM have hypertension,51 and the ADA recommends a BP goal of noting that lower targets may be appropriate in some patients.52 Lifestyle advice, including dietary changes and increased activity, is recommended for all patients with BP >120/80 mmHg, with pharmacotherapy for those with BP >140/90 mmHg. Typically, multiple drug therapy PFKM will be required, and should include an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin-receptor blocker.52 An SGLT2 inhibitor would not be chosen specifically to reduce BP or to replace an antihypertensive drug, but the magnitude of antihypertensive effects with empagliflozin might enable patients to achieve BP goals or to reduce their dose of diuretic. Empagliflozin was studied in patients IGF-1R inhibitor with T2DM and hypertension (mean seated systolic BP 130�C159 mmHg and diastolic BP 80�C99 mmHg).27 After 12 weeks, empagliflozin 10 and 25 mg significantly reduced mean 24-hour systolic BP, measured via ambulatory BP monitoring (ABPM), versus placebo (adjusted mean difference versus placebo in change from baseline in mean 24-hour systolic BP [ABPM] was �C3.44 mmHg [95% CI, �C4.78 to �C2.09] with 10 mg empagliflozin and �C4.16 mmHg [95% CI, �C5.50 to �C2.83] with 25 mg empagliflozin; P