New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s (British Journal of General Practice)
Diabetes News
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Identifying patients at increased risk of hypoglycaemia in primary care: Development of a machine learning‐based screening tool
Using demographic and medication data, a model for identifying patients at increased risk of hypoglycaemia was developed using machine learning. This model can be used as a tool in primary care to screen for patients with T2D who may need additional attention to prevent or reduce hypoglycaemic events (Diabetes/Metabolism Research and Reviews)
Metformin Benefits: Another Example for Alternative Energy Substrate Mechanism?
These effects may be considered as being to some extent similar to those produced by SGLT2is, another class of glucose-lowering agents with proven cardiorenal protection. The metabolic effects of metformin and SGLT2is may indeed have some similarities (Diabetes Care)
SGLT2 Inhibition Does Not Affect Myocardial Fatty Acid Oxidation or Uptake, but Reduces Myocardial Glucose Uptake and Blood Flow in Individuals With Type 2 Diabetes
SGLT2 inhibition does not affect myocardial FFA oxidation or uptake, but induces a shift in myocardial substrate utilization from glucose toward other sources, possibly ketone bodies. However, this shift in myocardial substrate utilization is quantitatively of minor importance and does not appear to improve either MEE or myocardial oxygen consumption. Therefore, it is unlikely to explain the striking cardioprotective benefit of SGLT2 inhibition. Of interest, SGLT2 inhibition reduces resting MBF, even when adjusting for cardiac workload (Diabetes)
Changes in Cardiovascular Biomarkers Associated With the Sodium–Glucose Cotransporter 2 (SGLT2) Inhibitor Ertugliflozin in Patients With Chronic Kidney Disease and Type 2 Diabetes
The effects of ertugliflozin on natriuretic peptides and neurohormones are preserved in patients with moderate CKD and consistent with plasma volume reduction. The rise in HCT without a change in erythropoiesis supports the volume contraction mechanism of SGLT2 inhibitor therapy. These effects may be important physiologically and contribute to a lower risk of CVD with SGLT2 inhibitor treatment in people with type 2 diabetes (Diabetes Care)
Comprehensive Psychosocial Screening in a Pediatric Diabetes Clinic
Comprehensive psychosocial screening can be effectively implemented as part of routine pediatric diabetes care and can identify adolescents in need of additional supports (Pediatric Diabetes)
Ready or not? Greater readiness for independent self‐care predicts better self‐management but not HbA1c in teens with type 1 diabetes
The current findings may point to a disconnect between how increased readiness for independent self‐care may translate into better perceived diabetes self‐management, but not into better HbA1c. In an effort to optimize HbA1c in teens with type 1 diabetes, future research is needed to design interventions that align perceived readiness for independent self‐care with self‐care behaviours that improve HbA1c (Diabetic Medicine)
Tirzepatide significantly reduced A1C and body weight in people with type 2 diabetes in two phase 3 trials from Lilly’s SURPASS program
Tirzepatide significantly reduced A1C and body weight in people with type 2 diabetes in two phase 3 trials from Lilly’s SURPASS program
SGLT-2 inhibitors and atrial fibrillation in the Food and Drug Administration adverse event reporting system
In a large pharmacovigilance database, AF was robustly and consistently reported more frequently for diabetes medications other than SGLT2i. This finding complements available evidence from trials supporting a protective role of SGLT2i against the occurrence of AF (Cardiovascular Diabetology)
Prognostic significance of diabetes mellitus in patients with atrial fibrillation
The presence of DM on top of AF was associated with substantially increased risk for all-cause or CV mortality, sudden cardiac death and excess morbidity (Cardiovascular Diabetology)
Cardiovascular surrogate markers and cardiometabolic therapeutics: a viewpoint learned from clinical trials on dipeptidyl peptidase-4 inhibitors
In this commentary we discuss how we should interpret the effects of cardiometabolic therapeutics on vascular surrogate markers, based on viewpoints learned from the results of clinical trials on dipeptidyl peptidase-4 inhibitors (Cardiovascular Diabetology)
Cardiovascular impact of new drugs (GLP-1 and gliflozins): the ABCD position statement
ABCD: The position statement is now on-line in The British Journal of Diabetes
Once-Weekly Semaglutide in Adults with Overweight or Obesity
In participants with overweight or obesity, 2.4 mg of semaglutide once weekly plus lifestyle intervention was associated with sustained, clinically relevant reduction in body weight (NEJM)
Sodium–glucose cotransporter 2 inhibitors reduce day‐to‐day glucose variability in patients with type 1 diabetes
SGLT2i improved day‐to‐day glucose variability and time in the target glucose range, without increasing frequency of hypoglycemia, in patients with type 1 diabetes, and reduced glycated hemoglobin, body mass and the required insulin dose (Journal of Diabetes Investigation)
Sodium–glucose cotransporter 2 inhibitor‐induced reduction in the mean arterial pressure improved renal composite outcomes in type 2 diabetes mellitus patients with chronic kidney disease: A propensity score‐matched model analysis in Japan
The degree of blood pressure reduction after SGLT2 inhibitor treatment influenced renal composite outcomes in Japanese type 2 diabetes mellitus patients with CKD, confirming the importance of blood pressure management in type 2 diabetes mellitus patients with CKD, even when they are under SGLT2 inhibitor treatment (Journal of Diabetes Investigation)
Trends in predominant causes of death in individuals with and without diabetes in England from 2001 to 2018: an epidemiological analysis of linked primary care records
The decline in vascular death rates has been accompanied by a diversification of causes in individuals with diagnosed diabetes and a transition from vascular diseases to cancers as the leading contributor to diabetes-related death. Clinical and preventative approaches must reflect this trend to reduce the excess mortality risk in individuals with diabetes (Lancet Diabetes & Endocrinology)
The comparative effects of intensive glucose lowering in diabetes patients aged below or above 65 years: results from the ADVANCE trial
Our results suggest that an intensive glycaemic control strategy to reduce HbA1c to 6.5% provided broadly similar benefits and harms and may be recommended for older, as well as younger, patients (Diabetes, Obesity and Metabolism)
Residual β cell function in long-term type 1 diabetes associates with reduced incidence of hypoglycemia
β Cell function can persist in long-duration T1DM. With a peak C-peptide concentration of >0.03 nmol/L, we observed clinically meaningful reductions in the prevalence of severe hypoglycemia (Journal of Clinical Investigation)
Acute glycaemic management before, during and after exercise for cardiac rehabilitation participants with diabetes mellitus
A joint statement of the British and Canadian Associations of Cardiovascular Prevention and Rehabilitation, the International Council for Cardiovascular Prevention and Rehabilitation and the British Association of Sport and Exercise Sciences (British Journal of Sports Medicine)
Use of Dipeptidyl Peptidase‐4 inhibitors and prognosis of COVID‐19 in hospitalized patients with type 2 diabetes: a propensity score analysis from the CORONADO study
These data support the safety of DPP‐4 inhibitors for diabetes management during the COVID‐19 pandemic and they should not be discontinued (Diabetes, Obesity and Metabolism)
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