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)
Diabetes News
Tag: GLP1
A randomized trial comparing the efficacy and safety of treating patients with very elevated hba1c levels with basal‐bolus insulin or a glp‐1 receptor agonist plus basal insulin
In patients with HbA1c≥10% treatment with GLP1RA plus basal insulin, compared with basal‐bolus insulin, resulted in better glycemic control and weight, lower insulin dosage and hypoglycemia, and improved quality of life. This treatment strategy is an effective and safe alternative to basal‐bolus insulin regimen (Diabetes, Obesity and Metabolism)
Incretin-Based Antihyperglycemic Agents for the Management of Acute Ischemic Stroke in Patients with Diabetes Mellitus: A Review
Several preclinical studies consistently showed that GLP-1 receptor agonists reduce infarct volume and improve the functional outcome after ischemic stroke. These beneficial effects appear to be mediated by anti-inflammatory, antioxidant, and anti-apoptotic actions of these agents (Diabetes Therapy)
Fracture Risk After Initiation of Use of Canagliflozin: A Cohort Study
In this study of middle-aged patients with type 2 diabetes and relatively low fracture risk, canagliflozin was not associated with increased risk for fracture compared with GLP-1 agonists (Annals of Internal Medicine)
Insulin and glucose‐lowering agents for treating people with diabetes and chronic kidney disease
Evidence concerning the efficacy and safety of glucose‐lowering agents for people with diabetes and CKD is limited. SGLT2 inhibitors and GLP‐1 agonists are probably efficacious for lowering glucose levels. Other potential effects of SGLT2 inhibitors include lower BP, lower potassium levels and a reduced risk of heart failure but an increased risk of genital infections. The safety of GLP‐1 agonists is uncertain (Cochrane Library)
Glucagon-like peptide-1 analogue liraglutide facilitates wound healing by activating PI3K/Akt pathway in keratinocytes
Our study suggests that liraglutide may be a potential target drug to improve skin ulcer with diabetes through its specific receptor GLP-1 (Diabetes Research and Clinical Practice)
Combination Therapy with GLP-1 Receptor Agonists and SGLT-2 Inhibitors in Older Patients with Type 2 Diabetes: a Real-World Evidence Study
This study’s findings provide evidence of clinically-meaningful reductions in HbA1c, body weight, and SBP in older T2D patients on combined regimens. The dropout and hypoglycemia rate were minimal and treatment was tolerated well (Canadian Journal of Diabetes)
Cardiovascular outcome studies in type 2 diabetes : comparison between SGLT2 inhibitors and GLP-1 receptor agonists
Currently, there is a paradigm shift in T2DM management, moving from a primary objective of glucose control to a cardiovascular and renal protection (Diabetes Research and Clinical Practice)
The effect of glucagon-like peptide 1 and glucagon-like peptide 1 receptor agonists on energy expenditure
This review indicates that GLP-1 has no short-term effect on REE but may decrease DIT. The GLP-1RA exenatide and liraglutide had a neutral effect on REE, although it was not possible to rule out an increase in REE following prolonged treatment (Diabetes Research and Clinical Practice)
Treatment Intensification in Type 2 Diabetes: A Real-World Study of 2-OAD Regimens, GLP-1 RAs, or Basal Insulin
Despite robust HbA1c lowering following treatment initiation, many patients did not achieve HbA1c < 7.0%. Basal insulin, generally prescribed for patients with high baseline HbA1c, was associated with a large reduction in HbA1c and with higher costs. Therapy intensification at an appropriate time could lead to clinical and economic benefits and should be investigated further (Diabetes Therapy)
Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes
In patients with type 2 diabetes, the use of SGLT-2 inhibitors or GLP-1 agonists was associated with better mortality outcomes than DPP-4 inhibitors (JAMA)
Insulin/Glucagon-Like Peptide-1 Receptor Agonist Combination Therapy for the Treatment of Type 2 Diabetes: Are Two Agents Better Than One?
We consider the benefits and limitations of these medications based on data from randomized clinical trials and discuss how they may address barriers to treatment intensification (Clinical Diabetes)
Combination of basal insulin and GLP-1 receptor agonist: is this the end of basal insulin alone in the treatment of type 2 diabetes?
This article reviews the efficacy and safety of different strategies to initiate and intensify basal insulin, with focus on new fixed ratio combinations of basal insulin with GLP-1 RAs available for use in a single injection pen (insulin degludec/liraglutide and insulin glargine/lixisenatide) (Diabetology & Metabolic Syndrome)
Contrasting effects on the risk of macrovascular and microvascular events associated with anti-hyperglycaemic drugs that enhance sodium excretion and lower blood pressure
Three classes of anti-hyperglycaemic medications are distinguished by their urinary sodium excretion-enhancing and blood pressure-lowering actions: long-acting glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors and sodium-glucose co-transporter-2 inhibitors (Diabetic Medicine)
Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis
Our findings show cardiovascular safety across all GLP-1 receptor agonist cardiovascular outcome trials and suggest that drugs in this class can reduce three-point major adverse cardiovascular events, cardiovascular mortality, and all-cause mortality risk, albeit to varying degrees for individual drugs, without significant safety concerns (The Lancet Diabetes & Endocrinology)
Cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: a meta-analysis
Our findings show cardiovascular safety across all GLP-1 receptor agonist cardiovascular outcome trials and suggest that drugs in this class can reduce three-point major adverse cardiovascular events, cardiovascular mortality, and all-cause mortality risk, albeit to varying degrees for individual drugs, without significant safety concerns. GLP-1 receptor agonists have a favourable risk–benefit balance overall, which should allow the choice of drug to be individualised to each patient’s needs (The Lancet Diabetes & Endocrinology)
Understanding the Gap Between Efficacy in Randomized Controlled Trials and Effectiveness in Real-World Use of GLP-1RA and DPP4 Therapies in Patients With Type 2 Diabetes
Poor medication adherence is primarily why RW effectiveness is significantly less than RCT efficacy, suggesting an urgent need to effectively address adherence among patients with type 2 diabetes (Diabetes Care)
Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom
Among GLP-1RA injection-experienced patients, key drivers of treatment preference for a hypothetical GLP-RA profile were side effects, efficacy, dosing frequency, and required preparation. Understanding patient preferences is important for optimizing treatment decision-making and improving treatment adherence (Diabetes Therapy)
Lowest Glucose Variability and Hypoglycemia Are Observed With the Combination of a GLP-1 Receptor Agonist and Basal Insulin (VARIATION Study)
The lowest GV and lowest hypoglycemia were observed in patients using the combination of basal insulin with a GLP-1 RA, supporting the complementary glycemic action of these agents in type 2 diabetes (Diabetes Care)
The sustained influence of metformin therapy on circulating GLP-1 levels in individuals with and without type 2 diabetes
In non-diabetic individuals, metformin increases total GLP-1 in a sustained manner and independently of changes in weight or glycaemia. Metformin-treated diabetic patients also have higher fasted GLP-1 independent of weight and glycaemia (Diabetes, Obesity and Metabolism)
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