Recent clinical studies (DAPA-HF, EMPEROR-Reduced and EMPEROR-Preserved, SOLOIST-WHF trial) and meta-analysis have demonstrated that sodium–glucose cotransporter-2 inhibitors (SGLT2i) are among the first antidiabetic drugs capable of reducing cardiovascular risks related to HF and improving the prognosis of patients with and without diabetes (Diabetes Therapy)
Diabetes News
Category: Medication
Review of SGLT2i for the Treatment of Renal Complications: Experience in Patients with and Without T2D
In this article, we briefly review the different mechanisms of action that may explain the renal beneficial effects of SGLT2i and disclose the results of the key renal outcome trials and the subsequent update of related clinical guidelines (Diabetes Therapy)
SGLT2 Inhibitors and the Cardiorenal Continuum: A Paradigm Shift in the Treatment of Patients with T2D
This supplement summarizes all the evidence of this therapeutic change and reviews the role of these drugs from prevention to management of patients who have already developed complications, such as patients with HF and chronic kidney disease (Diabetes Therapy)
Beyond the Glycaemic Control of Dapagliflozin: Impact on Arterial Stiffness and Macroangiopathy
Dapagliflozin can reduce arterial stiffness in people with T2DM, which is associated with an increased susceptibility to atherosclerosis regardless of age. Dapagliflozin is also associated with a significant decrease in BP and a favourable lipid profile, producing a decrease in the most atherogenic LDL fractions and an increase in HDL-C (Diabetes Therapy)
The selective serotonin reuptake inhibitor fluoxetine has direct effects at beta-cells to promote insulin secretion and increase beta-cell mass
These data are consistent with a role for fluoxetine in regulating glucose homeostasis through direct effects at beta-cells. Fluoxetine thus demonstrates promise as a preferential antidepressant for patients with concomitant occurrence of depression and diabetes (Diabetes, Obesity and Metabolism)
Gliflozins in the Management of Cardiovascular Disease
SGLT2 inhibitors are responsible for major paradigm shifts in the care of patients with or at high risk for heart failure, progression of chronic kidney disease, or both. SGLT2 inhibition improves cardiovascular outcomes in patients with heart failure over a wide range of ejection fractions, regardless of whether the patients have type 2 diabetes. In addition to having glucosuric and natriuretic properties, these agents also reduce the risk of end-stage kidney disease in patients with type 2 diabetes and chronic kidney disease (NEJM)
Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study
Neither metformin nor lifestyle reduced major cardiovascular events in DPPOS over 21 years despite long-term prevention of diabetes. Provision of group lifestyle intervention to all, extensive out-of-study use of statin and antihypertensive agents, and reduction in the use of study metformin together with out-of-study metformin use over time may have diluted the effects of the interventions (Circulation)
Once-Weekly Dulaglutide for the Treatment of Youths with Type 2 Diabetes
Treatment with dulaglutide at a once-weekly dose of 0.75 mg or 1.5 mg was superior to placebo in improving glycemic control through 26 weeks among youths with type 2 diabetes who were being treated with or without metformin or basal insulin, without an effect on BMI (NEJM)
Tirzepatide Once Weekly for the Treatment of Obesity
In this 72-week trial in participants with obesity, 5 mg, 10 mg, or 15 mg of tirzepatide once weekly provided substantial and sustained reductions in body weight (NEJM)
Fracture Risk of Sodium-Glucose Cotransporter-2 Inhibitors in Chronic Kidney Disease
In this cohort study of older adults, starting a SGLT2 inhibitor versus DPP-4 inhibitor was not associated with a higher risk of skeletal fracture, regardless of eGFR (Clinical Journal of the American Society of Nephrology)
Additional Insulin Dosing for Fat and Protein in Children with Type 1 Diabetes using Multiple Daily Injections
We found no benefit in giving additional insulin as a split dose for HFHP meals in children using MDI, mild hypoglycaemia was common. Future studies would benefit from refinement of the insulin dose algorithm (Pediatric Diabetes)
Newer long-acting insulin prescriptions for patients with type 2 diabetes: prevalence and practice variation in a retrospective cohort study
The inter-practice variation in the prescription of newer insulins is large and could only be partially explained by patient- and practice-related differences. This indicates substantial opportunities for improvement (British Journal of General Practice)
The current role of sodium-glucose cotransporter 2 inhibitors in type 2 diabetes mellitus management
The primary objective of this article is to examine the clinical benefit, safety, and tolerability of the four SGLT2 inhibitors approved by the US FDA. SGLT2 inhibitors increase urinary glucose excretion via inhibiting SGLT2 to decrease renal reabsorption of filtered glucose and reduce the renal threshold for glucose (Cardiovascular Diabetology)
Role of human organic cation transporter-1 (OCT-1/SLC22A1) in modulating the response to metformin in patients with type 2 diabetes
Taken together, our results corroborate the role of OCT-1 in the transport of metformin and also point at OCT1 genetic variations possibly affecting the transport of metformin into the cells and hence its subsequent action in responders and non-responders (BMC Endocrine Disorders)
Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin
As first-line T2D treatment, initiators receiving SGLT-2i showed a similar risk for MI/stroke/mortality, lower risk for HHF/mortality and HHF, and a similar safety profile except for an increased risk for genital infections compared with those receiving metformin (Annals of Internal Medicine)
Mediators of ertugliflozin effects on heart failure and kidney outcomes among patients with type 2 diabetes
In these analyses from the VERTIS CV trial, markers of volume status and haemoconcentration and/or haematopoiesis were the strongest mediators of the effect of ertugliflozin on reducing risk of HHF and composite kidney outcomes in the early and average change periods (Diabetes, Obesity and Metabolism)
Sitagliptin / Metformin hydrochloride Accord
On 19 May 2022, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a marketing authorisation for the medicinal product Sitagliptin/Metformin hydrochloride Accord, intended for the treatment of type 2 diabetes mellitus
Empagliflozin add-on therapy to closed-loop insulin delivery in type 1 diabetes: a 2 × 2 factorial randomized crossover trial
While no diabetic ketoacidosis or severe hypoglycemia occurred during any intervention, uncomplicated ketosis events were more common on empagliflozin. Empagliflozin 25 mg d−1 added to automated insulin delivery improves glycemic control but increases ketone concentration and ketosis compared to placebo (Nature Medicine)
Dorzagliatin add-on therapy to metformin in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled phase 3 trial
In patients with T2D who experienced inadequate glycemic control with metformin alone, dorzagliatin resulted in effective glycemic control with good tolerability and safety profile (Nature Medicine)
Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: a systematic review and meta-analysis
A dose-dependent superiority on glycaemic efficacy and body weight reduction was evident with tirzepatide vs placebo, GLP-1 RAs and basal insulin. Tirzepatide did not increase the odds of hypoglycaemia but was associated with increased incidence of gastrointestinal adverse events (Diabetologia)
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