As strategy-driven, head-to-head RCTs comparing SGLT-2i, GLP-1RA, or DPP-4i with metformin (and their combination with metformin) while ensuring glycemic and weight equipoise are unlikely to become available in the future, sharing and analyzing individual-level data from already conducted RCT would help to inform the evidence for the best first-line treatment(s) in subjects with type 2 diabetes and confirm or refute our finding (Diabetes Care)
Diabetes News
Tag: GLP-1RA
Impact of a Weekly Glucagon-Like Peptide 1 Receptor Agonist, Albiglutide, on Glycemic Control and on Reducing Prandial Insulin Use in Type 2 Diabetes Inadequately Controlled on Multiple Insulin Therapy: A Randomized Trial
A once-weekly GLP-1RA was able to substitute for prandial insulin in 54% of people, substantially reducing the number of prandial insulin injections; glycemic control improved, with the added benefits of weight loss and less hypoglycemia in the GLP-1RA arm (Diabetes Care)
Efficacy of Modern Diabetes Treatments DPP-4i, SGLT-2i, and GLP-1RA in White and Asian Patients With Diabetes
The glucose-lowering efficacy of SGLT-2i, and to a lesser extent DPP-4i, was greater in studies of predominantly Asian ethnicity compared with studies of predominantly white ethnicity. There was no difference seen by ethnicity for GLP-1RA (Diabetes Care)
Use of Glucagon-Like Peptide-1 Receptor Agonists in Patients With Type 2 Diabetes and Cardiovascular Disease
Findings from this review suggest that GLP-1RAs are safe, are well tolerated, and improve cardiovascular outcomes, largely independent of their antihyperglycemic properties, but they remain underused by cardiologists (JAMA Cardiology)
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)
Cardiovascular outcome trials of glucose-lowering medications: an update
In summary, taking into account the findings from these new studies, it is suggested that a GLP-1RA should be offered to all people with CVD and type 2 diabetes, and SGLT2 inhibitors should be prescribed for those at high risk of heart failure or with progressive decline in eGFR. DPP4 inhibitors are a safe choice within the glucose-lowering stepped algorithm (Diabetologia)
Effect of adding GLP-1RA on mortality, cardiovascular events and metabolic outcomes among insulin-treated patients with Type 2 Diabetes: A Large Retrospective UK Cohort Study
Based on a large UK cohort in routine clinical practice, adding a GLP-1RA to insulin therapy is associated with a reduction in risk of composite CV events and all-cause mortality, but non-significant higher risk of hospitalisation for heart failure in overweight patients with Type 2 diabetes (American Heart Journal)
Glucagon-like peptide-1 receptor agonists compared with basal insulins for the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis
Although weight reduction is seen with all GLP-1RA’s, only the once weekly agents, exenatide LAR and dulaglutide, demonstrate significant HbA1c reductions when compared to basal insulins (Diabetes, Obesity and Metabolism)
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