In this cohort study, initiation of long-acting analogs was associated with a lower risk of ED visits or hospitalizations for hypoglycemia compared with NPH insulin in older patients with type 2 diabetes in Medicare. However, this association was not seen with concomitant prandial insulin use (JAMA)
Diabetes News
Category: Medication
Effect of empagliflozin on ectopic fat stores and myocardial energetics in type 2 diabetes: the EMPACEF study
EMPA effectively reduced liver fat in mice and humans without changing epicardial, myocardial fat or myocardial energetics, rebutting the thrifty substrate hypothesis for cardiovascular protection of SGLT2 inhibitors (Cardiovascular Diabetology)
Results of a 24-Week Trial of Technosphere Insulin Versus Insulin Aspart in Type 2 Diabetes
Both TI and IA resulted in significant and clinically meaningful HbA1C reductions. TI also resulted in significant and clinically meaningful weight reductions. These data support the use of inhaled insulin as a treatment option for individuals with type 2 diabetes (Endocrine Practice)
Trends in diabetes medication use in Australia, Canada, England, and Scotland: a repeated cross-sectional analysis in primary care
New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s (British Journal of General Practice)
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)
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
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)
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)
GLP‐1 RA and atrial fibrillation in the cardiovascular outcome trials
This commentary suggests that the use of GLP‐1 RAs was not associated with an increased risk for incident atrial fibrillation reported as serious adverse event in individuals with type 2 diabetes who either have increased cardiovascular risk or established cardiovascular disease when compared to placebo (Diabetes/Metabolism Research and Reviews)
Essential diabetes medicines and health outcomes in 127 countries
Listing of diabetes medicines on NEMLs has the potential to improve population health outcomes related to mortality in countries with diverse incomes and diabetes prevalence without necessarily increasing diabetes health expenditure (Diabetes, Obesity and Metabolism)
Glucosuric, renal and hemodynamic effects of a dual inhibitor of SGLT1 and SGLT2, licogliflozin, in patients with chronic kidney disease: a randomized trial
Licogliflozin treatment results in significantly increased UGE and favorable changes in urinary electrolytes and hemodynamics in patients with varying degrees of CKD (eGFR≥45 mL/min/1.73 m2) (Diabetes, Obesity and Metabolism)
Evaluation of an implemented new insulin chart to improve quality and safety of diabetes care in a large university hospital: a follow-up study
The implementation of a structured documentation form together with training measures for healthcare professionals led to less documentation errors and safe management of glycaemic control in hospitalised patients in a short time follow-up. A rollout at further medical wards is recommended, and sustainability in the long-term has to be demonstrated (BMJ)
Effect of sodium–glucose cotransporter 2 inhibitors on cardiac structure and function in type 2 diabetes mellitus patients with or without chronic heart failure: a meta-analysis
The use of SGLT2i was associated with significant improvements in cardiac diastolic function, plasma NT-proBNP level, and the KCCQ score in T2DM patients with or without chronic HF, but did not significantly affect cardiac structural parameters indexed by body surface area. The LVEF level was improved only in HF patients with reduced ejection fraction (Cardiovascular Diabetology)
Metformin Use Is Associated With Reduced Mortality in a Diverse Population With COVID-19 and Diabetes
These results suggest that while diabetes is an independent risk factor for COVID-19-related mortality, this risk is dramatically reduced in subjects taking metformin prior to diagnosis of COVID-19, raising the possibility that metformin may provide a protective approach in this high risk population (Frontiers in Endocrinology)
Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure
In patients with diabetes and recent worsening heart failure, sotagliflozin therapy, initiated before or shortly after discharge, resulted in a significantly lower total number of deaths from cardiovascular causes and hospitalizations and urgent visits for heart failure than placebo (NEJM)
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