#1074

Lol.

Nope they didn’t.

1 Like
#1075

Empagliflozin Dampens Doxorubicin-Induced Chemobrain in Rats: The Possible Involvement of Oxidative Stress and PI3K/Akt/mTOR/NF-κB/TNF-α Signaling Pathways.

Abdelsalam RM, Hamam HW, Eissa NM, El-Sahar AE, Essam RM.

Mol Neurobiol. 2024 Sep 20. doi: 10.1007/s12035-024-04499-5. Online ahead of print.

PMID: 39302617

2 Likes
#1076

This paper here makes an offhand claim that empagliflozin and canagliflozin are insulin analogues, unlike dapagliflozin and other SGLT2i. I have never come across this claim elsewhere - can someone explain to me how these two in particular are insulin analogues while the others are not?

Key Quote:

“Regarding antidiabetic medication, metformin, gliclazide, pioglitazone, exenatide and dapagliflozin exert a beneficial effect on Endothelial Function (EF); glimepiride and glibenclamide, dipeptidyl peptidase-4 inhibitors and liraglutide have a neutral effect, while studies examining the effect of insulin analogues, empagliflozin and canagliflozin on EF are limited.”

1 Like
#1077

people on off-label SGLT2i: what biomarkers do you check to ensure you’re not hitting any negative side-effects? Also curious for anecdotes on positive side effects (e.g. lower post-prandial blood glucose etc.)

1 Like
#1078

I am not on empa, but soon will be. I intend to track my before/after biomarkers, obviously first and foremost blood sugar levels throughout the day, including morning and fasted with the help of a CGM; longer term A1c.

Then, liver and kidney panel for obvoius reasons, but also a basic lipid panel based on this PMID: 27207551

#1079

The negative side effects you really care about are the ones you can’t help but notice; urinary tract infection, etc. - see full list here: Canagliflozin (Oral Route) Side Effects - Mayo Clinic

But they seem to be relatively rare in healthy populations. I reported on my experience with canagliflozin in this thread: Canagliflozin for Anti-aging (part 2)

Since then I’ve been pulse dosing (month on, month off) empagliflozin generally with good results (no noticeable side effects) - but last month I noticed an increasing level of fatigue that was out of the ordinary after a few weeks of empagliflozin. So - right now I’m off it, and my energy has returned. I had a similar issue with canagliflozin. I’m not sure how I’ll manage this going forward - still evaluating. I also frequently take acarbose, especially on higher starch days when I’m not taking an SGLT2 inhibitor.

1 Like
#1080

This is very exciting evidence that the lifespan effect will translate to humans.

1 Like
#1081

I have lost weight on empagliflozin. That’s great as I am overweight. I have also increased my water intake. I find I am much thirstier. Drinking more water is a bonus IMHO.

4 Likes
#1082

Could that just be an error? I can’t find that SGLT2 inhibitors are insulin analogues?

#1083

I guess. I just find it really weird that they’d group the SGLTi that way. Both empa and dapa are SGLT2i, whereas cana is SGLT1/2i. Empa and dapa are much closer to each other, both being “2”, so if anything I imagine you’d group these two together. Instead they group empa and cana together, but dapa (presumably with other SGLTi) separately. Go figure. Meanwhile I’m trying to understand how these two are insulin analogues, because what do these two do functionally differently than dapa does?.. all get rid of glucose by a similar mechanism.

I’ve looked through pubmed, but didn’t see any papers reference SGLTi as insulin analogues, nor specifically empa and cana, in opposition to dapa. But I may have missed something.

1 Like
#1084

Weird. @AnUser if you have access to the full text: do they cite a source to back this claim?

#1085

Nope no access to that.

1 Like
#1086

I read this more carefully, and with my limited English skills, I concluded that it lists three categories: insulin analogues, empagliflozin, and canagliflozin, and states that their potential effect on EF are limited. So, it doesn’t claim that empagliflozin or canagliflozin are insulin analogues :slightly_smiling_face:

3 Likes
#1087

I have been feeling rather sleepy, weak and craving carbs in the past few weeks and my HbA1c is nearing the the lower 4.0 mark, so I am considering multiple options.

  1. lowering my current 12.5mg dose to 6.25mg
  2. taking 12.5mg in the evening only so that during the day my body has more sugar available
  3. taking it less regularly

Which option would you go for and why?

#1088

4% HbA1c?! This means an average glucose of 3.8 mg/dL so you might often be in hypoglycemia. Do you wear a CGM? Which other glucose lowering drugs do you take? (telmisartan lowers it a bit)

2 Likes
#1089

I only take 12.5mg empagliflozin and 20mg telmisartan. And yeah I think I could be in hypoglycemia although it hasn’t harmed my gym performance yet.

1 Like
#1090

Wear a CGM and check. Over time you can develop hypoglycemia unawareness.

5 Likes
#1091

Tj-long, I thinnk you are right! Yeah, now everything makes sense.

2 Likes
#1092

“The efficacy of combining two beneficial antidiabetes interventions, regular endurance exercise and SGLT2 inhibition, was not supported. SGLT2 inhibition blunted endurance exercise training-induced improvements in insulin sensitivity, independent of effects on aerobic fitness or body composition.” :thinking:

My theory on this is that the SGLT2i group has better fat metabolism, and glycogen stores are significantly depleted due to the SGLT2i medication and exercise, leading to a sharper rise in blood sugar after the workout. I’ve personally noticed, even without SGLT2 medications, that my blood sugar rises very easily after a long Zone 1-2 workout. I once posted a study here showing that well-trained individuals experienced a higher rise in blood sugar after a post-workout meal compared to less fit individuals.

It’s also interesting that endurance sports increase plasma volume, whereas SGLT2i reduces it. As I understand it, an increased plasma volume is one reason for a drop in resting heart rate. Has anyone noticed that SGLT2i raises resting heart rate?

Btw, some interesting comments in the study about metformin, statins, etc

5 Likes
#1093

Probably (hopefully!) not applicable to the audience of that forum.