SGLT2 inhibition increases serum copeptin in young adults with type 1 diabetes.

AIMS: Copeptin, a surrogate of vasopressin, is elevated in type 1 diabetes (T1D) and predicts kidney disease and cardiovascular mortality. Given the cardiorenal protective effects of SGLT2 inhibition (SGLT2i), our aim was to examine: 1) the relationship between serum copeptin, metabolic, renal and systemic hemodynamic parameters in adults with T1D; and 2) serum copeptin after SGLT2i with empagliflozin. MATERIALS AND METHODS: In this post-hoc, exploratory analysis, serum copeptin, glomerular filtration rate (GFRInulin), effective renal plasma flow (ERPFPAH), plasma renin angiotensin aldosterone system markers, HbA1c, 24-hour urine volume and sodium excretion were measured in 40 participants with T1D (24.3±5.1 years) during eu- and hyperglycaemia before and after 8 weeks of 25mg of daily empagliflozin. RESULTS: Higher baseline copeptin correlated with higher HbA1c, lower 24-hour urine volume and sodium excretion, after correcting for age, sex, systolic blood pressure, and HbA1c. Copeptin concentrations increased in response to empagliflozin under euglycaemia (4.1±2.1 to 5.1±2.8pmol/L, P=0.0053) and hyperglycaemia (3.3±1.4 to 5.6±2.8pmol/L, P<0.0001). The rise in copeptin in response to empagliflozin correlated with change in 24-hour urine volume, but was independent of changes in fractional excretion of sodium and haematocrit. CONCLUSIONS: Elevated serum copeptin was associated with worse glycaemic control and lower diuresis and natriuresis. SGLT2i increased serum copeptin in adults with T1D, and the rise correlated with change in diuresis, but not natriuresis and hemo-concentration. Further work is required to evaluate the clinical implications of elevated copeptin with SGLT2i, including whether it is simply a marker of diuresis or may contribute to cardiorenal disease long-term.

Concentrations of diazinon, chlorpyrifos, and bendiocarb after application in offices.

Airborne and surface concentrations of diazinon, chlorpyrifos (Dursban), and bendiocarb (Ficam) were measured at intervals up to 10 days after broadcast spray application onto the floors of seven offices. Results from this work can provide information to evaluate health hazards for workers and others entering treated buildings and can assist public agencies in setting guidelines or regulations. Diazinon and chlorpyrifos airborne concentrations peaked 4 hr after application at 163 and 27 micrograms/m3 of air sampled, respectively. The highest level of bendiocarb (2.7 micrograms/m3) was measured during treatment. Airborne concentrations measured for diazinon indicate that building occupants should not enter unventilated rooms for at least 2 days after spraying. Reentry into unventilated rooms 1 day after treatment with chlorpyrifos or bendiocarb would appear to be safe, however. Residues on aluminum plates and furniture were examined at intervals of up to 48 hr after spraying. In many cases, surface concentrations were higher at 24 or 48 hr than at 1 hr. Concentrations of residues removed from wood and painted metal furniture generally were higher than those on the aluminum plates. Peak residue concentrations were diazinon, 38 ng/cm2 of surface area sampled at 48 hr; chlorpyrifos, 5.9 ng/cm2 at 48 hr; and bendiocarb, 25 ng/cm2 at 1 and 24 hr. Workers who must enter buildings after insecticide application often are unaware of treatment plans and, therefore, are unable to take precautions to minimize their exposure. Inhalation and skin contact with insecticides can be reduced by providing office workers and building occupants with information on treatment times, health effects of insecticide overexposure, steps to take to reduce contact, and the perceived health risk. It is essential that treated areas be ventilated adequately before workers return to their offices.