Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect
Background. Diabetes mellitus is a highly prevalent disease with rapid universal growth. In 2013, there were already 382 million people with diabetes, and it is expected that by 2035, this number will double. Chronic hyperglycemia causes a series of biochemical and structural changes, especially in...
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Wiley
2020-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/4065452 |
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| author | Livia M. Zimmermann Mauricio S. Baptista João Paulo Tardivo Maria A. Pinhal |
| author_facet | Livia M. Zimmermann Mauricio S. Baptista João Paulo Tardivo Maria A. Pinhal |
| author_sort | Livia M. Zimmermann |
| collection | DOAJ |
| description | Background. Diabetes mellitus is a highly prevalent disease with rapid universal growth. In 2013, there were already 382 million people with diabetes, and it is expected that by 2035, this number will double. Chronic hyperglycemia causes a series of biochemical and structural changes, especially in the eyes, kidneys, heart, arteries, and peripheral nerves, which usually leads to the progression of microvascular disease. Several literature reports showed that the chronic use of phosphodiesterase-5 inhibitors enhances the insulin sensitivity, improves the markers of endothelial function, and helps in the treatment of severe extremity ischemia and pulmonary hypertension. We aim to test the effect of sildenafil citrate (SC) as a glucose and microcirculation regulator in diabetic patients, paying special attention to the consequences of its use in the regulation of blood glucose level. Case Presentation. Two male patients, aged 53 and 73 years, with type II diabetes, using oral hypoglycemic agents and presenting pathology associated with microcirculation alterations and ischemia, were medicated daily with SC. Both patients presented a reduction in the glycemic level, requiring lower doses or no other oral diabetes medications. Patient 1, who presented diabetic foot, was treated in the ambulatory, and patient 2, with chronic obstructive pulmonary disease and consequent mild pulmonary hypertension, was treated in the office. In addition to the clinical improvement of foot wounds and dyspnea due to the increase in microcirculatory perfusion, hypoglycemic episodes were observed in both patients under SC. The patient with pulmonary hypertension experienced one severe hypoglycemia episode and had to be taken to an emergency room. Conclusion. Type 2 diabetic patients may benefit from the use of a phosphodiesterase-5 inhibitor in order to improve the microcirculatory perfusion as well as glycemic control. However, adverse side effects may involve hypoglycemia. Since off-label use of SC in patients suffering from microcirculatory alterations has increased recently, our results showed that more studies are needed to verify the prevalence of hypoglycemia episodes as well as it's possible physiologic mechanism. |
| format | Article |
| id | doaj-art-94896529af4d41d594d40c19743dd474 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-94896529af4d41d594d40c19743dd4742025-02-03T06:43:40ZengWileyCase Reports in Medicine1687-96271687-96352020-01-01202010.1155/2020/40654524065452Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side EffectLivia M. Zimmermann0Mauricio S. Baptista1João Paulo Tardivo2Maria A. Pinhal3Faculdade de Medicina Do ABC, Santo André, BrazilUniversidade de São Paulo, Department of Biochemistry, Chemistry Institute, São Paulo, BrazilFaculdade de Medicina Do ABC, Santo André, BrazilFaculdade de Medicina Do ABC, Santo André, BrazilBackground. Diabetes mellitus is a highly prevalent disease with rapid universal growth. In 2013, there were already 382 million people with diabetes, and it is expected that by 2035, this number will double. Chronic hyperglycemia causes a series of biochemical and structural changes, especially in the eyes, kidneys, heart, arteries, and peripheral nerves, which usually leads to the progression of microvascular disease. Several literature reports showed that the chronic use of phosphodiesterase-5 inhibitors enhances the insulin sensitivity, improves the markers of endothelial function, and helps in the treatment of severe extremity ischemia and pulmonary hypertension. We aim to test the effect of sildenafil citrate (SC) as a glucose and microcirculation regulator in diabetic patients, paying special attention to the consequences of its use in the regulation of blood glucose level. Case Presentation. Two male patients, aged 53 and 73 years, with type II diabetes, using oral hypoglycemic agents and presenting pathology associated with microcirculation alterations and ischemia, were medicated daily with SC. Both patients presented a reduction in the glycemic level, requiring lower doses or no other oral diabetes medications. Patient 1, who presented diabetic foot, was treated in the ambulatory, and patient 2, with chronic obstructive pulmonary disease and consequent mild pulmonary hypertension, was treated in the office. In addition to the clinical improvement of foot wounds and dyspnea due to the increase in microcirculatory perfusion, hypoglycemic episodes were observed in both patients under SC. The patient with pulmonary hypertension experienced one severe hypoglycemia episode and had to be taken to an emergency room. Conclusion. Type 2 diabetic patients may benefit from the use of a phosphodiesterase-5 inhibitor in order to improve the microcirculatory perfusion as well as glycemic control. However, adverse side effects may involve hypoglycemia. Since off-label use of SC in patients suffering from microcirculatory alterations has increased recently, our results showed that more studies are needed to verify the prevalence of hypoglycemia episodes as well as it's possible physiologic mechanism.http://dx.doi.org/10.1155/2020/4065452 |
| spellingShingle | Livia M. Zimmermann Mauricio S. Baptista João Paulo Tardivo Maria A. Pinhal Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect Case Reports in Medicine |
| title | Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect |
| title_full | Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect |
| title_fullStr | Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect |
| title_full_unstemmed | Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect |
| title_short | Type II Diabetes Patients under Sildenafil Citrate: Case Series Showing Benefits and a Side Effect |
| title_sort | type ii diabetes patients under sildenafil citrate case series showing benefits and a side effect |
| url | http://dx.doi.org/10.1155/2020/4065452 |
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