SAJDVD: VOLUME 20, ISSUE
1, June
2023
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- From the Editor’s Desk
Authors: Mahomed, FA
From: South African Journal of Diabetes and Vascular Disease, Vol 20, Issue 1, June 2023
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- Empagliflozin significantly prevents QTc prolongation due to amitriptyline intoxication
Authors: VO Barış, E Gedikli, AB Dinçsoy, A Erdem
From: South African Journal of Diabetes and Vascular Disease, Vol 20, Issue 1, June 2023
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Aim: Empagliflozin (EMPA) is a sodium-glucose transporter-2 inhibitor used in the treatment of type 2 diabetes and has positive effects on cardiovascular outcomes. Amitriptyline (AMT) can be used in many clinical indications but leads to cardiotoxicity by causing QT prolongation. Our aim in this study was to determine how the effects of the concomitant use of empagliflozin and amitriptyline, which have been shown to have effects on sodium and calcium metabolism in cardiomyocytes, would cause an effect on QT and QTc intervals in clinical practice.
Methods: Twenty-four male Wistar albino rats were randomised into four groups. The control group received only physiological serum (1 ml) via orogastric gavage (OG). The EMPA group received empagliflozin (10 mg/kg) via OG. The AMT group received amitriptyline (100 mg/kg) via OG. The AMT+EMPA group (n = 6) received amitriptyline (100 mg/kg) and empagliflozin (10 mg/kg). Under anaesthesia, QT and QTc intervals were measured at baseline, and in the first and second hours.
Results: In the AMT group, QT intervals and QTc values were found to be statistically longer than in the control group (p ≤ 0.001). Empagliflozin significantly ameliorated amitriptyline-induced QT and QTc prolongation. In the AMT+EMPA group, QT and QTc intervals were significantly lower compared to that in the AMT group (p < 0.01)
Conclusion: In this study, we determined that empagliflozin significantly ameliorated amitriptyline-induced QT and QTc prolongation. This effect was probably due to the opposite effects of these two agents in the intracellular calcium balance. With more clinical trials, the routine use of empagliflozin may be suggested to prevent QT and QTc prolongation in diabetic patients receiving amitriptyline.
- Effect of insulin resistance on left ventricular remodelling in essential hypertensives: a crosssectional study
Authors: BK Phanzu, AN Natuhoyila, EK Vita, B Longo-Mbenza, J-R M’Buyamba Kabangu
From: South African Journal of Diabetes and Vascular Disease, Vol 20, Issue 1, June 2023
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Background: In clinical practice, left ventricular hypertrophy (LVH) is defined by physical findings and electrocardiographic criteria, which are useful but imperfect tools, echocardiographic criteria and cardiac magnetic resonance imaging. In echocardiography, LVH is defined not by left ventricular wall thicknesses but by left ventricular mass. The latter is calculated according to Devereux’s formula, and is increased by insulin resistance/hyperinsulinaemia. It is however unclear whether insulin resistance, hyperinsulinaemia, or both, is actually causative and what their collective or individual influence is on the components of Devereux’s formula and parameters of left ventricular diastolic function. This study evaluated the associations of the homeostatic model assessment for insulin resistance (HOMAIR) and fasting plasma insulin levels with components of Devereux’s formula and parameters of left ventricular diastolic function.
Methods: Relevant clinical data were collected from 220 hypertensive patients recruited between January and December 2019. The associations of components of Devereux’s formula and parameters of diastolic function with insulin resistance were tested using binary ordinal, conditional and classical logistic regression models.
Results: Thirty-two (14.5%) patients (43.9 ± 9.1 years), 99 (45%) patients (52.4 ± 8.7 years) and 89 (40.5%) patients (53.1 ± 9.8 years) had normal left ventricular geometry, concentric left ventricular remodelling and concentric left ventricular hypertrophy, respectively. In multivariable adjusted analysis, 46.8% of variation in interventricular septum diameter (R² = 0.468; overall p = 0.001) and 30.9% of E-wave deceleration time (R² = 0.309; overall p = 0.003) were explained by insulin level and HOMAIR, 30.1% of variation in left ventricular end-diastolic diameter (R² = 0.301; p = 0.013) by HOMAIR alone, and 46.3% of posterior wall thickness (R² = 0.463; p = 0.002) and 29.4% of relative wall thickness (R² = 0.294; p = 0.007) by insulin level alone.
Conclusions: Insulin resistance and hyperinsulinaemia did not have the same influence on the components of Devereux’s formula. Insulin resistance appeared to act on left ventricular end-diastolic diameter, while hyperinsulinaemia affected the posterior wall thickness. Both abnormalities acted on the interventricular septum and contributed to diastolic dysfunction via the E-wave deceleration time.
- Potential benefits of cinnamon for type 2 diabetes
Author: C Mohan
From: South African Journal of Diabetes and Vascular Disease, Vol 20, Issue 1, June 2023
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Introduction: While COVID-19 dominated headlines in 2021 another more insidious plague continued unabated. At that time, there were 24 million adults between the ages of 20 and 79 years in Africa living with diabetes. Worryingly that figure continues to rise. By 2030, an estimated 33 million people on the continent will be affected by this disease. In many ways, diabetes can be considered to be the dark horse of non-infectious diseases. It is not as widely discussed as HIV, cancer or malaria in the African context, however in 2021 it was responsible for 416 000 African deaths.
- Painkillers linked to heart failure in type 2 diabetes: Danish study
Author: MedcialBrief 2023
From: South African Journal of Diabetes and Vascular Disease, Vol 20, Issue 1, June 2023
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Introduction: At just three years old, Liezl was diagnosed as diabetic. ‘My mom noticed I was losing weight and drinking lots of water, and I wanted to eat a lot of tomato sauce because I was craving the sweetness. She also says my breath smelled sweet. Now we recognise these as symptoms of uncontrolled diabetes, and diabetic acidosis, a shortage of insulin in the body that prevents blood sugar from getting to the cells to be used as energy,’ says Liezl, now 34 years old.
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RELIABLE EXPERT INFORMATION
The SAJDVD’s main focus is
providing new and relevant information for doctors,
nurses and allied professionals involved in caring
for the diabetes patient.
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
