dapa

2. SGLT2 Acts on Kidneys:
Kidney made of 1 million tiny tubes called Nephron.
Nephron is responsible for:

3. Major 5 parts of Nephron:

4. Glomerulus and Convoluted Tubule are after the cortex of kidney,
Loop of henle and Collection duct past on into the medulla of kidney

5. Blood filtration starts with Glomerulus

6. Water and others molecules were reaborped by convoluted
tubule, loop of henle and collecting duct, rest will go via urine

7. The normal filteration there is no glucose in urine

8. The proximal tubule is not having capacity to reabsorp all the glucose, then
we start to see glucose appear in urine

9. SGLT2 Action:
Sodium and glucose possibly defuse the other side of the cell

11. Glucose secreted in the urine and the blood glucose stays low,
there is no reabsorbtion in proximal tubule.

12. Dapablis Inhibitory Action
• Significant reduction in HbA1c
• Effective control of FPG
• Low Risk of Hypoglycemia
• CV benefits
• Reduction in BP
• Weight loss

13. Dapablis M
• More effective than metformin Monotherapy
for weight loss in patients with class 3 obesity,
prediabetes or diabetes who are awaiting for
bariatic surgery.
• Provides A1C decrease of upto 2%, Weight
loss of 2-3 kg & modest sbp decrease of 3-
5mmhg

14. Heart Failure

16. Ejection Fraction

17. Not able to do the regular activities

18. Novel SGLT2 Inhibitor in HF

19. SGLT2 in HF
• Dapagliflozin also reduces sodium
reabsorption and increases the delivery of
sodium to the distal tubule.
• This may influence several functions including,
but not restricted to, lowering both pre- and
afterload of the heart and downregulation of
sympathetic activity.

20. • SGLT2 inhibition can result in a 30% to 60% increase in
urinary sodium excretion.
• By lowering blood pressure, SGLT2 inhibitors may lower
cardiac afterload, with resultant improvement in
ventricular arterial coupling and cardiac efficiency,
downregulation of sympathetic activity.
• This would be expected to benefit the failing heart.
• FDA approved Dapagliflozin for the treatment of heart
failure with reduced ejection fraction in adults with
and with out T2DM.