Empagliflozin and Dapagliflozin Improve Endothelial Function in Mexican Patients with Type 2 Diabetes Mellitus: A Double-Blind Clinical Trial.

AIM: To assess the acute effect of empagliflozin versus dapagliflozin administration on flow-mediated vasodilation in patients with type 2 diabetes mellitus. DESIGN: A double-blind clinical trial, at the Experimental and Clinical Therapeutics Institute, University Health Sciences Center, at the Universidad de Guadalajara, in inpatients with T2D according to the 2023 ADA criteria. METHODS: Thirty patients (15 males and 15 females), aged between 35 and 65 years, were included in this study, according to the 2023 ADA criteria. The eligible patients were randomly assigned to three groups: empagliflozin 25 mg once daily, dapagliflozin 10 mg once daily, or placebo once daily. Anthropometric parameters were taken using validated techniques. FMD was measured using a high-resolution semiautomatic ultrasound UNEX-EF 38G (UNEX Co., Ltd., Nagoya, Japan). Arterial tension was determined with the OMRON electronic digital sphygmomanometer (HEM 907 XL, Kyoto, Japan). RESULTS: The group of patients who received empagliflozin had a significantly lower baseline flow-mediated dilation (FMD) compared to the group receiving dapagliflozin (p = 0.017); at the end of this study, the empagliflozin group achieved a comparable FMD to the dapagliflozin group (p = 0.88). CONCLUSION: After the treatment period, the empagliflozin and dapagliflozin groups achieved similar FMD, suggesting a class effect.

Administration of Herbarium Mixture (Guazuma ulmifolia/Tecoma stans) on Metabolic Profile in Type 2 Diabetes Mellitus Patients: A Randomized, Double-Blind, Placebo-Controlled Trial.

The use of herbarium mixture has been empirical, and the properties are not yet known. The aim of this study was to evaluate the effect of oral administration of herbarium mixture (Guazuma ulmifolia [G. ulmifolia]/Tecoma stans [T. stans]) on metabolic profile in patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled, clinical trial was carried out in 40 patients with T2DM. They were between 40 and 65 years of age, with body mass index (BMI) between 25.0 and 34.9 kg/m2 and HbA1c >7.0%. BMI, waist circumference, fasting glucose, HbA1c, lipids, kidney, and liver function were measured. The patients were randomly assigned to receive the herbarium mixture (G. ulmifolia/T. stans) 400 mg before each meal, or placebo for 90 days. Herbarium mixture group showed decreased waist circumference (99 ± 14 vs. 98 ± 15 cm; P = .019), fasting glucose (12.0 ± 5.7 vs. 10.3 ± 5.1 mM; P = .019), and HbA1c (9.9% ± 2.7% vs. 8.9% ± 2.5%, P = .002). In conclusion, the administration of herbarium mixture (G. ulmifolia/T. stans) improved the glycemic profile in patients with T2DM. ClinicalTrial registration: NCT03313856 ClinicalTrials.gov.

Behavior of visfatin in nonobese women undergoing liposuction: a pilot study.

INTRODUCTION: The adipocyte has recently begun to be considered not just as a fat deposition tissue, but also as a true endocrine organ. Adipose tissue produces a wide variety of adipocytokines, of which visfatin is one. OBJECTIVE: Since visfatin has recently been described as a mimic of insulin action, the authors evaluate visfatin behavior in women undergoing liposuction. MATERIALS: Nineteen nonobese women underwent liposuction of abdominal fat. Patient visfatin levels and a lipid profile were obtained preoperatively, and the results were compared with the results of the same tests immediately postoperatively and one month postoperatively. RESULTS: The mean age of the 19 study participants was 33 years; mean body mass index was 24.7±2.2 kg/m2. The amount of subcutaneous fat obtained was an average of 4468±1403 kg. Visfatin increased from 51.8±24.4 ng/mL preoperatively to 76.3±39.8 ng/mL (P=.02). Pre- and postoperative lipid profiles reflected, respectively, the following: total cholesterol, 159.1±37.1 vs 164.6±31.7 mg/dL (P=.420); high-density cholesterol, 41.4±8.6 vs 39.3±9.9 mg/dL (P=.421); low-density cholesterol, 97.1±25.4 vs 100±19.2 mg/dL (P=.507); and triglycerides, 92.3±57.1 vs 126.3±72.5 mg/dL (P=.058). CONCLUSIONS: Visfatin levels were shown to increase after liposuction of subcutaneous fat. The authors conclude that this adipocyte may play an important role as a regulatory reciprocal mechanism.

Effect of ezetimibe on insulin sensitivity and lipid profile in obese and dyslipidaemic patients.

AIM: To evaluate the effect of ezetimibe on insulin sensitivity and lipid profile in obese and dyslipidaemic patients. METHODS: A randomized, double-blind, placebo-controlled clinical trial was carried out in 12 obese, dyslipidaemic patients, independently of their basal insulin sensitivity. At the beginning of the study, a metabolic profile was measured, and insulin sensitivity estimated using the euglycaemic-hyperinsulinaemic clamp technique. The volunteers were randomly assigned to receive ezetimibe (10 mg/day in the morning) or placebo for a period of 90 days. After intervention, a similar metabolic profile was measured and a second clamp study was performed. RESULTS: Ezetimibe administration for 90 days decreased total (6.0 +/- 0.5 vs. 4.2 +/- 0.9 mmol/L, p = 0.011) and low-density lipoprotein (4.0 +/- 0.7 vs. 2.2 +/- 0.8 mmol/L, p=0.003) cholesterol concentrations without modification of insulin sensitivity (3.0 +/- 0.6 vs. 2.9 +/- 0.7 mg/kg/min, p = 0.345). CONCLUSIONS: Ezetimibe significantly decreased total cholesterol and low-density lipoprotein cholesterol concentrations without affecting insulin sensitivity in obese and dyslipidaemic patients.