drugs to improve nutrient status (because that makes sense)

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drugs to improve nutrient status (because that makes sense)

Postby jimmylegs » Mon Mar 13, 2017 9:46 am

Effects of Canagliflozin on Serum Magnesium in Patients With Type 2 Diabetes Mellitus: A Post Hoc Analysis of Randomized Controlled Trials (2017)
https://link.springer.com/article/10.10 ... 017-0232-0

Abstract
Introduction
The objective of this study was to evaluate the effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on serum magnesium in hypomagnesemic patients with type 2 diabetes.

Methods
This post hoc analysis was based on pooled data from four placebo-controlled studies of canagliflozin (N = 2313). The proportion of patients with baseline serum magnesium <0.74 mmol/L who achieved serum magnesium ≥0.74 mmol/L at week 26 was evaluated.

Results
At week 26, canagliflozin 100 and 300 mg increased serum magnesium versus placebo in patients with baseline serum magnesium <0.74 mmol/L (17.0% and 19.0% vs 3.9%) and ≥0.74 mmol/L (4.9% and 7.0% vs −1.4%). More patients with baseline serum magnesium <0.74 mmol/L had serum magnesium ≥0.74 mmol/L at week 26 with canagliflozin 100 and 300 mg versus placebo (74.1% and 80.6% vs 28.8%).

Conclusions
Canagliflozin was associated with normalization of serum magnesium in hypomagnesemic patients with type 2 diabetes, potentially leading to improved cardiometabolic outcomes.

ah, good old 'normal'... i'm sorry but serum mag 0.74 mmol/L is *not* my idea of a suitable cutoff for health. stopping after the first step into a flawed normal range is not helpful. 'potential' improvements indeed...
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
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jimmylegs
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Re: drugs to improve nutrient status (because that makes sen

Postby jimmylegs » Mon Mar 13, 2017 9:50 am

COMPARING THE EFFECT OF DULOXETINE WITH GABAPENTIN IN THE TREATMENT OF DIABETIC PERIPHERAL NEUROPATHY: A RANDOMIZED CLINICAL TRIAL
http://en.journals.sid.ir/ViewPaper.aspx?ID=483501
Background: Diabetic neuropathy is the most common micro-vascular complications of diabetes. The drugs including gabapentin and duloxetine are often used for the treatment of pain associated with diabetic neuropathy. This study aimed to compare the efficacy of duloxetine and gabapentin in the treatment of diabetic peripheral neuropathy.
Materials and methods: Totally, 34 patients aged 40 to 70 with diabetic neuropathy were randomly divided into two groups treated with duloxetine and gabapentin and received medical treatment for 45 days. Patients were evaluated for pain before and after treatment using visual analog scale, and also their serum glucose and zinc levels were measured.
Results: In both groups statistically significant reduction in mean blood glucose, pain scale, as well as an increase in serum zinc levels at the end of the study was observed compared to baseline. There was no significant difference between the two groups for the mean decrease in blood sugar, but the increase in duloxetine group showed significant improvement compared to gabapentin in increase serum zinc levels and reducing pain.
Conclusion: The use of duloxetine in patients with diabetic neuropathic pain is more effective than gabapentin because duloxetine causes a better increase in the serum zinc. Due to the high price of duloxetine in the treatment of diabetic neuropathy, gabapentin administration can be recommended during the first phase of disease and duloxetine can be used in poor and/or insufficient response.
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
Volunteer Moderator
 
Posts: 10430
Joined: Sat Mar 11, 2006 4:00 pm

Re: drugs to improve nutrient status (because that makes sen

Postby jimmylegs » Mon Mar 13, 2017 10:55 am

Nonenzymatic antioxidants of blood in multiple sclerosis
https://link.springer.com/article/10.10 ... 4150050399
Abstract
Free radical action has been suggested as a causal factor in multiple sclerosis. We investigated the plasma level of lipid peroxides expressed in terms of malone dialdehyde and changes in blood nonenzymatic antioxidants (glutathione, α-tocopherol, retinol, plasma sulfhydryl groups, and uric acid) in multiple sclerosis patients with exacerbation or in remission, including a group treated with β-interferon. The malone dialdehyde level was increased by 38% (n.s.) during exacerbations. The blood concentration of oxidized glutathione was likewise elevated (P < 0.05), while the ratio of plasma α-tocopherol to cholesterol plus triglyceride was decreased (P < 0.001). These changes suggest increased free radical production and consumption of the scavenger molecules during the active phase of the disease. Blood reduced glutathione level was increased (P < 0.01) during exacerbation and remission as well. The rise in this thiol is likely to be a compensatory mechanism defending the cells from further oxidant injuries. β-Interferon increased plasma α-tocopherol levels (P < 0.001) but not the lipid corrected α-tocopherol value. Other parameters were not influenced by the drug.
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
Volunteer Moderator
 
Posts: 10430
Joined: Sat Mar 11, 2006 4:00 pm

Re: drugs to improve nutrient status (because that makes sen

Postby jimmylegs » Mon Mar 13, 2017 11:04 am

Fat-soluble vitamins as disease modulators in multiple sclerosis (2013)
full text pdf http://bit.ly/2nmpkRx
Observational studies – Jime´nez-Jime´nez et al. (57) compared cerebrospinal fluid and serum levels of vitamin E in 36 patients with MS and 32 matched controls. They found that the serum levels of vitamin E and the serum vitamin E/cholesterol ratio were significantly lower in patients with MS than controls (P < 0.05 and P < 0.01). The values were, however, not correlated with age, age at onset and duration of the disease in the patients group. Besler et al. (19) replicated these findings and found that vitamin E levels were lower in 24 patients with MS than in 24 controls (P < 0.05).
The findings were also replicated by Salemi et al. (58). They described lower levels of vitamin E (P = 0.001) in 40 patients with MS than in 80 healthy controls. It has also been reported that the ratio of plasma vitamin E to cholesterol and triglyceride are decreased (P < 0.001) during MS exacerbations and increased during treatment with b-interferon (59). In a follow-up study, 14 patients with relapsing-remitting MS were followed during 6 months with interferon-b treatment (60). It was reported that erythrocyte vitamin E level was reduced (P < 0.001) before treatment, but had regained the same level as in controls after 6 months of interferon therapy.[/b] The authors concluded that interferon treatment seemed to exert a sparing effect toward the erythrocyte vitamin E content (60).
Clinical trials – No uncontrolled or controlled clinical trials have been published on how vitamin E supplementation may influence the disease course of MS.

well at least we know that when they do get around to implementing such trials, that dietary sources should be emphasized and that both form and dose of any vit e supplements should be done with careful attention to natural ratios of alpha tocopherols to the other components of the E8 tocopherol and tocotrienol complex. don't need another SELECT fiasco.
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
Volunteer Moderator
 
Posts: 10430
Joined: Sat Mar 11, 2006 4:00 pm

Re: drugs to improve nutrient status (because that makes sen

Postby jimmylegs » Wed Aug 16, 2017 4:15 am

Elevated serum magnesium associated with SGLT2 inhibitor use in type 2 diabetes patients: a meta-analysis of randomised controlled trials
https://www.ncbi.nlm.nih.gov/pubmed/27628105
"RESULTS:
Eighteen eligible RCTs, including 15,309 patients and four SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin and ipragliflozin) were evaluated. In patients without chronic kidney disease, each SGLT2 inhibitor significantly increased serum magnesium levels compared with placebo (canagliflozin: WMD 0.06 mmol/l for 100 mg and 0.09 mmol/l for 300 mg; dapagliflozin: WMD 0.1 mmol/l for 10 mg; empagliflozin: WMD 0.04 mmol/l for 10 mg and 0.07 mmol/l for 25 mg; and ipragliflozin: WMD 0.05 mmol/l for 50 mg). Canagliflozin increased serum magnesium in a linear dose-dependent manner (p = 0.10). Serum phosphate was significantly increased by dapagliflozin. Serum sodium appeared to significantly differ by SGLT2 inhibitor type. No significant changes in serum calcium and potassium were observed. Findings were robust after including trials involving patients with chronic kidney disease.
CONCLUSIONS/INTERPRETATION:
SGLT2 inhibitors marginally increased serum magnesium levels in type 2 diabetes patients indicating a drug class effect. Further investigations are required to examine the clinical significance of elevated magnesium levels in individuals with type 2 diabetes."

pretty sure we have a good stack of those investigations kicking around in the literature already, but by all means let's get started on dismantling that brutal 'normal' range.

feed farmers, not pharma. eat your magnesium.
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
Volunteer Moderator
 
Posts: 10430
Joined: Sat Mar 11, 2006 4:00 pm


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