PodcastsThe Peter Attia Drive#279 - AMA #53: Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin, GLP-1 agonists, and the impact of statins

#279 - AMA #53: Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin, GLP-1 agonists, and the impact of statins
The Peter Attia DriveSun Nov 12 2023
SGLT-2 Inhibitors:
- SGLT2 inhibitors prevent the kidney from reabsorbing glucose and sodium, leading to increased excretion of these substances in the urine.
- They are used to manage type 2 diabetes by lowering glucose levels and have been found to reduce hemoglobin A1C by up to 1.8% when combined with metformin.
- These inhibitors, such as canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin, have demonstrated additional benefits beyond glycemic control, including a reduction in blood pressure and improved cardiovascular outcomes in patients with heart failure.
Development of SGLT-2 Inhibitors:
- SGLT2 inhibitors were developed based on the naturally occurring substance fluorescein, which induced glucose urea in non-diabetic individuals when administered.
- The chemical structure of SGLT2 inhibitors is derived from fluorescein, providing a foundation for drug development that has led to multiple variations of these drugs being approved for use.
Geroprotective Potential:
- SGLT2 inhibitors have shown potential as geroprotective molecules due to their effects on reducing major adverse cardiac events and improving cardiovascular outcomes in patients with heart failure, even in those without type 2 diabetes.