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: Medication
Efficacy and safety of the SGLT2 inhibitor empagliflozin versus placebo and the DPP-4 inhibitor linagliptin versus placebo in young people with type 2 diabetes (DINAMO): a multicentre, randomised, double-blind, parallel group, phase 3 trial
Empagliflozin provided clinically relevant placebo-corrected reductions in HbA1c, whereas linagliptin did not, and might offer a new treatment option for young people with type 2 diabetes (The Lancet Diabetes & Endocrinology)
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)
Direct comparison two fixed-ratio combination glucagon-like peptide receptor agonist and basal insulin on glycemic and non glycemic parameters in type 2 diabetes
Our results showed that more patients with iDegLira had HbA1c less than 7% and these combination had better effect on weight loss. There was no difference observed in FPG and PPG, lipid profile and rate of hypoglycaemia (BMC Endocrine Disorders)
Meta-Analysis of Head-to-Head Clinical trials Comparing Incretin-Based Glucose-Lowering Medications and Basal Insulin – An Update Including Recently Developed GLP-1 Receptor Agonists and the GIP/GLP-1 Receptor Co-Agonist Tirzepatide
In particular, recently introduced, highly effective IBGLM were superior over basal insulin treatment, reinforcing the recommendation that IBGLM should be considered as the first injectable treatment for most patients with type 2 diabetes (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)
The real-world safety profile of sodium-glucose co-transporter-2 inhibitors among older adults (≥ 75 years): a retrospective, pharmacovigilance study
In this global post-marketing study, none of the adverse events was reported more frequently among older adults. Our findings provide reassurance regarding SGLT2i treatment in older adults, although careful monitoring is warranted (Cardiovascular Diabetology)
Therapeutic inertia related to the injectable glucagon-like peptide-1 receptor agonists dulaglutide and semaglutide in patients with type 2 diabetes in UK primary care
Multiple examples of therapeutic inertia were identified, including first prescription at HbA1c levels considerably above target and failure to escalate to optimal doses even with evidence of suboptimal metabolic control. A substantial proportion of patients therefore did not achieve optimal HbA1c targets (Diabetes, Obesity and Metabolism)
Identifying diabetogenic drugs using real world healthcare databases: a Danish and Australian symmetry analysis
We identified 70 drug-diabetes associations, of which 27 were classified as hitherto unknown. Further studies evaluating the hypotheses generated by this work are needed, particularly for the signal for digitalis glycosides (Diabetes, Obesity and Metabolism)
Efficacy of Dapagliflozin by Baseline Diabetes Medications: A Prespecified Analysis From the DAPA-CKD Study
Dapagliflozin reduced kidney and cardiovascular events in patients with type 2 diabetes and CKD across baseline GLT class or classes in combination (Diabetes Care)
Effects of Dapagliflozin on Hospitalizations in Patients With Chronic Kidney Disease
Dapagliflozin reduced the risk for hospitalization for any cause in patients with CKD with and without type 2 diabetes (Annals of Internal Medicine)
Insulin degludec versus insulin detemir, both in combination with insulin aspart, in the treatment of pregnant women with type 1 diabetes (EXPECT): an open‑label, multinational, randomised, controlled, non-inferiority trial
In pregnant women with type 1 diabetes, degludec was found to be non-inferior to detemir (The Lancet Diabetes & Endocrinology)
Time–Action Profile of Technosphere Insulin in Children with Type 1 Diabetes
Serum insulin rapidly increased post-dose and returned to baseline by 120 min. The data suggests the PK of TI in youth with T1D ages 8–17 years was similar to that seen in previous adult studies (Diabetes Therapy)
Efficacy and safety of sitagliptin treatment in older adults with moderately controlled type 2 diabetes: the STREAM study
The STREAM study revealed that sitagliptin treatment effectively improved the glycemic profile without any serious adverse effects, including self-reported hypoglycemia, in older T2D patients (Nature Briefing)
Neuroprotective properties of DPP-4i: A therapeutic target for dementia prevention in elderly diabetic patients?
Regarding prevention, as it remains unclear whether the administration of drugs with neuroprotective effects (DPP-4i, GLP-1 receptor agonists etc.) would reduce the incidence and progression of small vessel disease or the progression of brain atrophy, it will be necessary to explore the respective associations in prospective research (Journal of Diabetes Investigation)
Pre-admission use of sodium glucose transporter-2 inhibitor (SGLT-2i) may significantly improves Covid-19 outcomes in patients with diabetes
This study suggests that SGLT-2i as glucose lowering treatment in patients with diabetes has a positive effect on Covid-19 outcomes, therefore can be considered as an antidiabetic drug of choice, especially during the Covid-19 pandemic (Diabetes Research and Clinical Practice)
Oral Insulin (ORMD-0801) in Type 2 Diabetes Mellitus: Dose-Finding 12-Week Randomized Placebo-Controlled Study
Oral insulin (ORMD-0801) induced greater reductions in HbA1c when compared to placebo and was safe and well-tolerated in individuals with uncontrolled T2DM (Institute of Endocrinology, Metabolism & Hypertension )
An Indirect Comparison of Basal Insulin Plus Once-Weekly Semaglutide and Fully Optimised Basal–Bolus Insulin in Type 2 Diabetes
In T2D uncontrolled by basal insulin, intensification with semaglutide 1.0 mg OW was associated with better glycaemic control, weight loss, and reduced hypoglycaemia versus a basal–bolus regimen, while limiting the treatment burden associated with frequent injections. Clinicians could consider treatment intensification with semaglutide when T2D is uncontrolled by basal insulin, especially when weight management is a priority (Diabetes Therapy)
Mounjaro
The European Medicines Agency therefore decided that Mounjaro’s benefits are greater than its risks and it can be authorised for use in the EU
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)
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