Our results demonstrated that EMPA, mainly acting on SGLT2, prevented DNA methylation changes induced by high glucose and provided evidence of a new mechanism by which SGLT2i can exert cardio-beneficial effects (Cardiovascular Diabetology)
Diabetes News
Category: Cardiovascular
Empagliflozin in Adults with Chronic Kidney Disease (CKD): Current Evidence and Place in Therapy
Empagliflozin is the latest SGLT2i drug to show proven benefits in both hyperglycemia, CV disease, heart failure, and now CKD progression. The new EMPA-KIDNEY data proves that it provides benefits in patients with and without diabetes and can be used in those with eGFR down to 20 mL/min/1.73m (Therapeutics and Clinical Risk Management)
Kidney function measures and cardiovascular outcomes in people with diabetes: the Hoorn Diabetes Care System cohort
This study showed differential and independent prospective associations between manifestations of early kidney damage in diabetes and several CVD subtypes, suggesting that regular monitoring of both kidney function measures may help to identify individuals at higher risk of specific cardiovascular events (Diabetologia)
Cardiovascular outcomes trial data from EMPA-REG OUTCOME, CAROLINA, and CARMELINA: assessment of a novel staging system for type 2 diabetes
Applying the DSS across T2D clinical trial populations with different CV risk revealed significantly increased risk for ACM and CV death with higher DSS stage. The DSS may benefit from assessment in other T2D populations and with evaluation of the impact of additional outcomes, such as heart failure (Diabetes, Obesity and Metabolism)
Impact of baseline kidney function on the effects of SGLT2 inhibitors on kidney and heart failure outcomes: a systematic review and meta-analysis of randomized controlled trials
SGLT2i reduce risk of renal and HF outcomes for all eGFR categories. The greatest benefits in terms of kidney protection may be achieved by early initiation of SGLT2i in people with preserved eGFR. Greatest risk reduction for HF outcomes is observed in people with lower eGFR values (Diabetes, Obesity and Metabolism)
Associations Between Mean HbA1c, HbA1c Variability, and Both Mortality and Macrovascular Complications in Patients with Diabetes Mellitus: A Registry-Based Cohort Study
Both low (< 6.0% [42 mmol/mol]) and high (≥ 8.0% [64 mmol/mol]) levels of glycaemic control are associated with increased all-cause mortality and diabetes-related macrovascular complications. Glycaemic variability is independently associated with increased risk for these outcomes. Therefore, patients with stable glycaemic level of 6– 8% (42– 64mmol/mol) are at lowest risk of all-cause mortality and diabetes-related macrovascular complications (Clinical Epidemiology)
Cardiovascular outcomes in type 1 and type 2 diabetes
As illustrated by the literature discussed above, comparison between individuals with type 1 and type 2 diabetes with respect to risk of CVD is fraught with difficulties and highly dependent on other concomitant factors, some of which are modifiable and others not (Diabetologia)
High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank
Small HDL-P were inversely associated with incident CVD and all-cause mortality and improved risk stratification for adverse outcomes in people with T2D. HDL-P may be used as markers for residual risk in people with T2D (Cardiovascular Diabetology)
Microvascular Disease and the Pathogenesis of Heart Failure in Diabetes: A Tiny Piece of the Tricky Puzzle
Development of HF in diabetes is a complex and multifactorial process that involves different mechanisms (Diabetes Care)
Validation of a Risk Prediction Model for Early Chronic Kidney Disease in Patients with Type 2 Diabetes: Data from the German/Austrian DPV Registry
The predictive model achieved moderate discrimination but good calibration in a German/Austrian T2D population suggesting that the model may be relevant for determining CKD risk (Diabetes, Obesity and Metabolism)
Personalized management of dyslipidemias in patients with diabetes—it is time for a new approach (2022)
Overall, patients with diabetes should be carefully examined in terms of CV risk stratification (e.g., taking into consideration TOD, renal function, subclinical atherosclerosis, etc.), to define their lipid goals. We strongly suggest that, for such high-risk patients, LDL-C target should be achieved as early as possible to maximize CVD prevention (Cardiovascular Diabetology)
Protection against stroke with glucagon-like peptide-1 receptor agonists: a comprehensive review of potential mechanisms
The available evidence remains however insufficient to confirm whether other effects of GLP-1RAs such as direct cardioprotective actions (i.e., effects on atrial electrical remodeling, increased left ventricular ejection fraction, increased myocardial salvage, effects on cardiac oxidative metabolism) and effects on the microvascular function may mechanistically contribute to GLP-1RA-mediated protection against stroke (Cardiovascular Diabetology)
Impact of sodium-glucose cotransporter-2 inhibitors on heart failure and mortality in patients with cancer
The use of SGLT2i was associated with a lower rate of incident HF and prolonged overall survival in patients with cancer with diabetes mellitus (Heart Journal)
Long-term cardiovascular outcomes of gestational diabetes mellitus: a prospective UK Biobank study
GDM was associated with more diverse cardiovascular outcomes than previously considered, and conventional risk factors such as diabetes, hypertension, and dyslipidemia partially contributed to this relationship (Cardiovascular Diabetology)
Effects of tirzepatide versus insulin glargine on kidney outcomes in type 2 diabetes in the SURPASS-4 trial: post-hoc analysis of an open-label, randomised, phase 3 trial
Our analysis suggests that in people with type 2 diabetes and high cardiovascular risk, tirzepatide slowed the rate of eGFR decline and reduced UACR in clinically meaningful ways compared with insulin glargine (The Lancet Diabetes & Endocrinology)
Trends in the Association Between Diabetes and Cardiovascular Events, 1994-2019
In this large, population-based study, the magnitude of the association between diabetes and risk of cardiovascular events decreased, while that between CVD and such events remained stable. These results suggest that diabetes is still an important cardiovascular risk factor but no longer equivalent to CVD—a change that likely reflects the use of modern, multifactorial approaches to diabetes (JAMA)
Risk of adverse events with liraglutide in heart failure with reduced ejection fraction: A post hoc analysis of the FIGHT trial
In patients with HFrEF, liraglutide might increase the risk of cardiovascular adverse effects, an effect possibly driven by excess risk of arrhythmias and worsening HF events (Diabetes, Obesity and Metabolism)
Sodium–glucose co-transporter-2 (SGLT2) inhibitors in type 2 diabetes: are clinical trial benefits for heart failure reflected in real-world clinical practice? A systematic review and meta-analysis of observational studies
Real-world SGLT2 inhibitor use support randomised trial data for the size effect of reduced hospitalisation for heart failure in type 2 diabetes, although with a much lower ARR in people without CVD (Diabetes, Obesity and Metabolism)
Prospects of stem cell therapy for diabetic microvascular complications
The main therapeutic mechanisms of stem cell transplantation are angiogenesis/vasoprotective, neuroprotective and anti-inflammatory effects. As these therapeutic mechanisms of stem cell transplantation are consistent with the developmental mechanism of diabetic microvascular complications, its therapeutic effect can be promising (Journal of Diabetes Investigation)
Association between triglyceride glucose index and atherosclerotic plaques and Burden: findings from a community-based study
Elevated TyG index was associated with increased odds of atherosclerosis in coronary/intra- and extracranial arteries. Compared with HOMA-IR, the TyG index was more strongly associated with intracranial atherosclerosis. Moreover, discordantly high TyG index with HOMA-IR was also important for atherosclerosis identification (Cardiovascular Diabetology)
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