health and remedies
Combinations of medications may aid in reducing the progression of diabetic kidney damage
Combining SGLT2 inhibitors — a newer class of diabetes treatments that reduces blood sugar — with older diabetes meds may help to halt the onset of diabetic kidney impairment, according to a mouse study led by Washington University School of Medicine in St. Louis. Dapagliflozin (Farxiga), empagliflozin (Jardiance), and canagliflozin (Canagliflozin) are some of the most commonly prescribed SGLT2 inhibitors (Invokana).
Kidney disease is the largest cause of death in the United States, impacting 37 million people, many of whom are unaware that their kidneys are failing. There is no cure, and the only therapies for end-stage renal disease are dialysis and kidney transplantation.
A mouse study headed by Washington University School of Medicine in St. Louis reveals that combining SGLT2 inhibitors — a newer class of diabetes treatments that reduces blood sugar — with older diabetes drugs may help to halt the course of diabetic kidney impairment.
Dapagliflozin (Farxiga), empagliflozin (Jardiance), and canagliflozin (Canagliflozin) are some of the most commonly prescribed SGLT2 inhibitors (Invokana). Janssen Pharmaceuticals, whose experts cooperated on this study, produces the latter.
Diabetic kidney disease affects roughly 40% of type 2 diabetes patients, resulting in renal failure, cardiovascular disease, and early death. Diabetes, renal disease, and kidney failure are more common in African Americans, Native Americans, and Hispanics than in Caucasians.
Diabetes harms the kidneys by preventing them from filtering waste and extra fluids from the body adequately. Most people don’t recognise they have kidney disease until irreversible organ damage occurs since symptoms including nausea, vomiting, sleep difficulties, and swelling limbs are common and nonspecific.
SGLT2 inhibitors, also known as sodium-glucose cotransporter-2 inhibitors, cause the kidneys to excrete excess sugar from the blood, which is then excreted through urine. Humphreys, who is also the Joseph Friedman Professor of Renal Diseases in Medicine, added, “This family of medications is also very protective for heart disease.”
Although most patients with type 2 diabetes are prescribed only one medicine, the findings of this study show that combination therapy may be more successful since different drug classes target different cell types in the kidney.
The researchers examined how mouse kidneys respond to five diabetes therapy regimens administered to people using mice that had developed diabetic kidney damage. The researchers used single-cell RNA sequencing to look for alterations in the kidneys at the cellular and molecular level as a result of the various therapies. Researchers can use this knowledge to better target certain cells in order to improve medication therapy.
They focused on the impact of three kinds of drugs: SGLT2 inhibitors, angiotensin converting enzyme inhibitors (ACE inhibitors), such as Lisinopril, and Thiazolidinediones (TZD, also known as insulin sensitizers). A common TZD is rosiglitazone.
The study’s first author, Haojia Wu, PhD, an assistant professor in the Division of Nephrology, said, “We structured this study to try to understand how combination medicines affect the kidney differently than single therapies.” “We discovered that each of the distinct classes of medications targeted different cell types, offering a biological justification for combination therapy to help diabetic kidney disease advance more slowly.”
The study discovered that combining SGLT2 inhibitors with Lisinopril showed superior kidney protection than either of the standalone treatments.
SGLT2 inhibitors also appeared to mislead the kidney into initiating a starvation response, similar to how the body slows down its metabolism while fasting for long periods of time, according to the researchers.
This could lower the kidney’s overall energy consumption, allowing it to perform more efficiently and putting less strain on it in the long run, which could explain why this family of medications is so effective,” Humphreys added.
“Treatments for diabetic kidney disease are at an all-time high,” he noted. “Our research adds to the growing body of data that combining medicines has significant benefits for patients.” Such techniques, we believe, should be used in ordinary clinical practise.”
Future observational studies in persons using combo medicines, according to Humphreys, should provide more data.
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health and remedies
How to stay fit during Diwali 2024: Diet tips, easy workouts, tricks to manage stress during the festive season
Staying on track with your fitness goals during Diwali season can be challenging. These expert-recommended tips can help you stay active amid the festivities.
Diwali 2024: How can you stop feeling bloated, tired, and stressed out during the festive season? What should you eat at Diwali parties? How can you stay fit and look your best? If you, too, are wondering how to stay healthy during the festive season and control your calorie intake while also eating and doing what you want, you have come to the right place. Also read | Dussehra to Diwali holiday health tips: Stress management during the festive rush
Even the most disciplined people can find it difficult to stick to their health routines during the festive season. But you can make things different this year. All that eating and socialising does not have to set you back on your fitness goals.
To help keep you on track, we’ve enlisted the aid of leading experts in health, fitness and nutrition for some much-needed advice. If you tend to get a little anxious around the festive season, don’t miss these simple tips and tricks to follow:
Nutrition and diet tips for Diwali festivities
Payal Kothari, nutritionist and author of The Gut, has shared with HT Lifestyle her tips on how to enjoy Diwali parties without compromising gut health. She says, “The festive season is filled with irresistible treats and family gatherings, but it doesn’t mean you have to compromise on your health goals.”
She suggests opting for healthier alternatives without missing out on the joy of eating; but the key word there is balance. “Choose nutrient-dense snacks like roasted nuts, baked samosas, and fresh fruit platters over fried foods. Moderation is key — enjoy your sweets, but keep portion sizes in check,” Payal says.
Dr Kiran Soni, head of the department of Nutrition and Health at Yatharth Hospitals Greater Noida, adds that to maintain health and fitness during Diwali, you should focus on portion control rather than completely rejecting your favourite dishes.
“Fill your plate primarily with vegetables and lean proteins, leaving smaller portions for sweets and fried items. Stay hydrated; when attending parties, eat a small protein-rich snack beforehand to avoid overindulging,” she says.
Another one of your non-negotiables this festive season should be staying hydrated. Payal says, “Focus on staying hydrated by drinking plenty of water, herbal teas, and infused water to flush out toxins and curb overeating. Drink soup at home if you can, and then head out, or eat a small protein meal before heading out.”
Easy workouts to fit into your festive schedule
It’s not easy to fit in your workouts during the festive season, but even if exercise isn’t quite your top priority during the month of October, you can still move to stay active. Dr Soni says, “Maintaining physical activity is crucial during the festive season. Aim for short, high-intensity workouts when time is limited. Consider morning yoga or stretching sessions to energize your day. Take walks after heavy meals to aid digestion and burn calories.”
Payal recommends short, effective workouts, such as a 15-20-minute HIIT session, 20-30 burpees yoga stretches, or even a brisk walk. She says, “If you’re attending family gatherings or parties, use the opportunity to stay active—dance during celebrations. Being the first one to initiate the moves on the dance floor can help digest the extra food and burn those calories. Or go for a walk with your loved ones. Even 10 minutes of stretching in the morning can improve your energy levels and help you feel your best.”
How to manage stress during the festive season
Diwali season can bring a lot of stress and strain on your mental health, ranging from mild annoyances to the types of anxieties that keep you up at night. And as you probably know, exercise is a great way to relieve all of that. Another truth: what you eat matters too.
Payal suggests adding mood-boosting and stress-relieving foods to your diet, like dark leafy greens, almonds, and foods rich in Omega-3s, such as chia seeds and flaxseeds. She says, “Soups are great for gut-brain health.”
Dr Soni adds, “Managing stress is essential for overall well-being during busy festive periods. Incorporate stress-reducing foods into your diet, such as foods rich in omega-3 fatty acids (like fatty fish, walnuts, and flaxseeds), complex carbohydrates (whole grains, vegetables), and magnesium-rich foods (leafy greens, legumes). Prioritise sleep and maintain a consistent sleep schedule as much as possible.”
Other coping mechanisms? “Practise mindfulness by incorporating short meditation or deep breathing exercises into your day, even if it’s just for five minutes. Prioritise quality sleep, and try to set aside a few moments of ‘me time’ to recharge. By making these small adjustments, you can enjoy the festivities guilt-free while maintaining a balance between health and celebration,” Payal says.
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