Adding semaglutide to SGLT-2 inhibitor therapy significantly improves glycaemic control and reduces bodyweight in patients with inadequately controlled type 2 diabetes, and is generally well tolerated (The Lancet Diabetes & Endocrinology)
Diabetes News
Category: Medication
Update in Cardiovascular Safety of Incretin-Based Therapy in Adults with Type 2 Diabetes Mellitus: A Meta-Analysis of Cardiovascular Outcome Trials
This meta-analysis demonstrated that GLP-1RAs were associated with a significant reduction in MACE, CV death, stroke, and death from any cause, while DPP-4 inhibitors were comparable to placebo for all CV outcomes, including hospitalizations for HF (Canadian Journal of Diabetes)
Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in type 1 diabetes: meta-analysis of randomised controlled trials
In type 1 diabetes, sotagliflozin improves glycaemic and non-glycaemic outcomes and reduces hypoglycaemia rate and severe hypoglycaemia. The risk of diabetic ketoacidosis could be minimised by appropriate patient selection and down-titration of the basal insulin dose (BMJ)
DPP‐4 inhibitors lower the risk of autoimmune disease in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study
In this large population‐based cohort study, upfront DPP4i combination therapy was associated with a lower risk of composite AD compared with initial non‐DPP4i combination therapy (British Journal of Clinical Pharmacology)
Impact of metformin use on the cardiovascular effects of dipeptidyl peptidase‐4 inhibitors: An analysis of Medicare claims data from 2007 to 2015
Incidence rate differences in multiple CV outcomes appeared more favourable when DPP‐4 inhibitor initiation occurred in the presence of metformin, suggesting a possible interaction between DPP‐4 inhibitors and metformin (Diabetes, Obesity and Metabolism)
Cost‐effectiveness of intensification with sodium‐glucose co‐transporter‐2 inhibitors in patients with type 2 diabetes on metformin and sitagliptin vs direct intensification with insulin in the United Kingdom
or UK patients with T2D not at goal on metformin and sitagliptin therapy, treatment intensification with SGLT2 inhibitors prior to NPH insulin is cost‐neutral or cost‐effective compared with immediate NPH insulin intensification (Diabetes, Obesity and Metabolism)
Double‐blind, randomized clinical trial comparing the efficacy and safety of continuing or discontinuing the dipeptidyl peptidase‐4 inhibitor sitagliptin when initiating insulin glargine therapy in patients with type 2 diabetes
When initiating insulin glargine therapy, continuation of sitagliptin, compared with discontinuation, resulted in a clinically meaningful greater reduction in HbA1c without an increase in hypoglycaemia (Diabetes, Obesity and Metabolism)
Safer insulin prescribing
This document summarises the evidence base on safer insulin prescribing. It is a key therapeutic topic that has been identified to support medicines optimisation. It is not formal NICE guidance
Type 2 diabetes mellitus: medicines optimisation priorities
This document summarises the evidence base on type 2 diabetes mellitus: medicines optimisation priorities. It is a key therapeutic topic that has been identified to support medicines optimisation. It is not formal NICE guidance
Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea
Among adults with type 2 diabetes uncontrolled with metformin with or without sulfonylurea, oral semaglutide, 7 mg/d and 14 mg/d, compared with sitagliptin, resulted in significantly greater reductions in HbA1c over 26 weeks, but there was no significant benefit with the 3-mg/d dosage. Further research is needed to assess effectiveness in a clinical setting (JAMA)
The Future of the GLP-1 Receptor Agonists
Overall, the findings of the PIONEER 3 trial, along with other recent studies, indicate that the introduction of semaglutide, the first oral preparation of a GLP-1RA for which the subcutaneous agent has shown positive cardiovascular benefit, should be an important addition to the growing list of pharmacologic options for type 2 diabetes (JAMA)
Metformin attenuates the postprandial fall in blood pressure in type 2 diabetes
Metformin acutely attenuates the hypotensive response to oral glucose, associated with augmented GLP‐1 secretion and delayed gastric emptying, effects potentially relevant to its favourable cardiovascular profile (Diabetes, Obesity and Metabolism)
Sodium-Glucose Cotransporter-2 Inhibitors (SGLT-2i) Reduce Hospitalization for Heart Failure Only and Have No Effect on Atherosclerotic Cardiovascular Events: A Meta-Analysis
The predominant impact of SGLT-2i is on “hHF or CV mortality” composite driven predominantly by reduction in hHF and not atherosclerotic CV disease (Diabetes Therapy)
Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial
Adding semaglutide to SGLT-2 inhibitor therapy significantly improves glycaemic control and reduces bodyweight in patients with inadequately controlled type 2 diabetes, and is generally well tolerated (The Lancet Diabetes & Endocrinology)
Time trends in prescribing of type 2 diabetes drugs, glycemic response and risk factors: a retrospective analysis of primary care data, 2010‐2017
Recent changes in prescribing of therapy in type 2 diabetes have not led to a change in glycemic response and have resulted in modest improvements in other population‐level short‐term patient outcomes (Diabetes, Obesity and Metabolism)
Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials
Based on the results shown in the clinical trials, we will be able to select more optimal class and drug according to the individual patients’ clinical characteristics. This would lead to the desirable selection of glucose-lowering agents and ‘Tailored Medication’ in diabetes care (Cardiovascular Diabetology)
Sotagliflozin, the first dual SGLT inhibitor: current outlook and perspectives
In this review we illustrate the advantages and disadvantages of dual SGLT 2/1 inhibition, in order to better characterize and investigate its mechanisms of action and potentialities (Cardiovascular Diabetology)
The effect of short-term intensive insulin therapy on circulating T cell subpopulations in patients with newly diagnosed type 2 diabetes mellitus
Short-term intensive insulin therapy could modulate circulating T cell subpopulations in patients with T2DM, which might alleviate inflammatory responses caused by hyperglycemia
International Consensus on Risk Management of Diabetic Ketoacidosis in Patients with Type 1 Diabetes Treated with Sodium-Glucose Cotransporter (SGLT) Inhibitors
This consensus report reviews current data regarding SGLT- inhibitor use and provides recommendations to enhance the safety of SGLT-inhibitors in people with type 1 diabetes (Diabetes Care)
Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type 2 diabetes mellitus and chronic kidney disease
Currently available data suggest that despite only modest reductions in glycated hemoglobin, SGLT2 inhibitors reduce the risk of cardiovascular and renal outcomes in patients with T2DM and CKD, without clear evidence of additional safety concerns (Diabetes, Obesity and Metabolism)
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