An Oral Drug That May Protect Against Heart Failure As Well As Lower Blood Sugar

Dapagliflozin (Farxiga) is an SGLT2 inhibitor, given in the form of a pill for people who have been diagnosed with Type 2 diabetes and is used along with diet and exercise and sometimes with other medications. It works by making the kidneys secrete more sugar into the urine. According to a study reported on in October of 2018 in the journal Cardiovascular Diabetology, the drug is also helpful for treating heart failure, one complication of Type 2 diabetes.

Heart failure takes place when the left side of the heart is unable to take in blood from the lungs and send it out fast enough to the rest of the body.

The heart is made up of muscle tissue which grows when it is stressed. Inward growth of this muscle makes for a smaller space to accommodate blood flowing in from the lungs. This causes the heart to fail, filling the lungs with fluid from the blood.

In 2017 an estimated 26 million people worldwide had heart failure. In Type 2 diabetes high blood sugar levels damage the heart and blood vessels, and high blood pressure can result. It is vital to bring down the blood pressure reading to a healthy level to lower the strain on the heart. Heart attacks may not cause chest pain in people with Type 2 diabetes because nerve damage reduces sensation. That makes preventing heart disease even more imperative.

Investigators at Kobe University and several other research facilities in Japan looked at 58 people who had Type 2 diabetes and who also had heart failure. Dapagliflozin at a dose of 5 mg/day was added to their usual regimen. After six months the muscle tissue comprising the left side of the diabetic's heart decreased in size. Brain natriuretic peptide (BNP), a protein secreted by the heart cells in response to being stretched too far, lowered in the participants whose BNP was extremely high. From this information, the researchers concluded dapagliflozin could be helpful for improving heart failure in those who have Type 2 diabetes.

The natriuretic peptide is effective in making the kidneys secrete potassium into the kidneys, lowering the blood pressure and the amount of blood in the heart and blood vessels.

Dapagliflozin is given once a day, either with or without food. It is prescribed as part of an overall treatment plan that includes diet and exercise. Side effects include...

• urinary tract yeast infections,
• a stuffy nose with a sore throat,
• frequently urinating in more copious amounts and at night,
• dizziness or light-headedness,
• ketoacidosis (check for ketones in urine),
• nausea and vomiting,
• feeling very tired,
• having difficulty with breathing,
• abdominal pain, and
• kidney injury.