Evidence-based recommendations on dapagliflozin (Forxiga) with insulin for treating type 1 diabetes not controlled by insulin therapy alone in adults with a body mass index (BMI) of at least 27 kg/m2 (NICE)
Diabetes News
Category: Medication
Ticagrelor in Patients with Stable Coronary Disease and Diabetes
In patients with stable coronary artery disease and diabetes without a history of myocardial infarction or stroke, those who received ticagrelor plus aspirin had a lower incidence of ischemic cardiovascular events but a higher incidence of major bleeding than those who received placebo plus aspirin (NEJM)
Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes
In type 2 diabetes, while sitagliptin has no effect on either gastric emptying or postprandial blood pressure, it’s effects to lower postprandial glucose is dependent on the basal rate of gastric emptying (Diabetes, Obesity and Metabolism)
Lack of Durable Improvements in β-Cell Function Following Withdrawal of Pharmacological Interventions in Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes
In adults with IGT or recently diagnosed type 2 diabetes, interventions that improved β-cell function during active treatment failed to produce persistent benefits after treatment withdrawal. These observations suggest that continued intervention may be required to alter the progressive β-cell dysfunction in IGT or early type 2 diabetes (Diabetes Care)
PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes
In patients with type 2 diabetes, oral semaglutide monotherapy demonstrated superior and clinically relevant improvements in HbA1c (all doses) and body weight loss (14 mg dose) versus placebo, with a safety profile consistent with other GLP-1 receptor agonists (Diabetes Care)
What Next After Metformin? Thinking Beyond Glycaemia: Are SGLT2 Inhibitors the Answer?
There is growing evidence to illustrate the overall safety profile of this class of agents and support the benefit–risk profile of SGLT2 inhibitors as a preferred option following metformin monotherapy failure, with respect to both kidney disease progression and heart failure outcomes (Diabetes Therapy)
Liraglutide in Children and Adolescents with Type 2 Diabetes
In children and adolescents with type 2 diabetes, liraglutide, at a dose of up to 1.8 mg per day (added to metformin, with or without basal insulin), was efficacious in improving glycemic control over 52 weeks. This efficacy came at the cost of an increased frequency of gastrointestinal adverse events (NEJM)
Metformin Use and Clinical Outcomes among Patients with Diabetes with or without Heart Failure or Kidney Dysfunction
In a cohort of 12,156 patients with T2DM and high CV risk, metformin use was associated with lower rates of all-cause mortality, including after adjustment for clinical variables and biomarkers, but not lower rates of the composite endpoint of CV death, MI, or ischemic stroke (Circulation)
Class effects of SGLT2 inhibitors on cardiorenal outcomes
Dapagliflozin, empagliflozin, and canagliflozin have internally and externally consistent and biologically plausible class effects on cardiorenal outcomes. Baseline renal filtration function and degree of albuminuria are the most significant indicators of risk for both CV and renal events. Thus, these two factors also anticipate the greatest clinical benefit for SGLT2i (Cardiovascular Diabetology)
Dapagliflozin vs Non‐SGLT‐2i Treatment is Associated with Lower Hospital Care Costs in Type 2 Diabetes Patients Similar to the DECLARE‐TIMI 58 Participants
In a nationwide, real‐world, DECLARE‐like population, dapagliflozin was associated with lower hospital costs compared with oGLD, mainly as a result of reduced rates of CV‐ and T2D‐associated complications (Diabetes, Obesity and Metabolism)
The future is now: SGLT2 inhibitors and type 1 diabetes – what about exercise?
This novel drug class, which has received wide attention in its glucose-lowering and cardiovascular-protective properties in the management of type 2 diabetes, also bears potential for individuals with T1D who are struggling with achieving glycaemic targets
Sodium–Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections: A Population-Based Cohort Study
In a large cohort of patients seen in routine clinical practice, risk for severe and nonsevere UTI events among those initiating SGLT-2 inhibitor therapy was similar to that among patients initiating treatment with other second-line antidiabetic medications (Annals of Internal Medicine)
Investigating the risk of bone fractures in elderly patients with type 2 diabetes mellitus: a retrospective study
In elderly patients with T2DM, the key factor associated with fractures was the use of thiazolidines in both males and females (BMC Endocrine Disorders)
Mechanisms of action of metformin with special reference to cardiovascular protection
mMetformin remains well placed to support improvements in cardiovascular outcomes, from diagnosis and throughout the course of type 2 diabetes, even in this new age of improved outcomes in type 2 diabetes (Diabetes/Metabolism Research and Reviews)
Dapagliflozin Plus Saxagliptin Add-on Therapy Compared With Insulin in Patients With Type 2 Diabetes Poorly Controlled by Metformin With or Without Sulfonylurea Therapy
Adding DAPA + SAXA to insulin-naive patients with poorly controlled type 2 diabetes achieved similar glycemic control, a lower risk of hypoglycemia, and a clinically relevant body weight difference compared with basal INS (Diabetes Care)
Metabolic effectiveness of gliflozins and gliptins in the routine clinical practice of patients with type 2 diabetes: preliminary results from GIOIA, a prospective multicentre study
Both SGLT-2i and DPP-4i provide substantial improvements in metabolic parameters in the usual clinical practice of T2D, especially when used as second-line treatment
The future of new drugs for diabetes management
The future of the newer classes of glucose-lowering drugs, namely dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium/glucose co-transporter-2 (SGLT-2) inhibitors, is being redefined by the large prospective cardiovascular outcome trials (Diabetes Research and Clinical Practice)
Glycaemic, weight, and blood pressure changes associated with early versus later treatment intensification with dapagliflozin in United Kingdom primary care patients with type 2 diabetes mellitus
Glycaemic benefits were greater with early versus later dapagliflozin intensification. These results support broader and earlier dapagliflozin use (Diabetes Research and Clinical Practice)
Dapagliflozin with insulin for treating type 1 diabetes
Recommendations (NICE)
Exploring Patient Preferences for Adjunct-to-Insulin Therapy in Type 1 Diabetes
Low-dose SGLTi profile was the favored adjunct-to-insulin therapy by persons with T1D (Diabetes Care)
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