Empagliflozin is the latest SGLT2i drug to show proven benefits in both hyperglycemia, CV disease, heart failure, and now CKD progression. The new EMPA-KIDNEY data proves that it provides benefits in patients with and without diabetes and can be used in those with eGFR down to 20 mL/min/1.73m (Therapeutics and Clinical Risk Management)
Diabetes News
Tag: SGLT2 inhibitors
Impact of baseline kidney function on the effects of SGLT2 inhibitors on kidney and heart failure outcomes: a systematic review and meta-analysis of randomized controlled trials
SGLT2i reduce risk of renal and HF outcomes for all eGFR categories. The greatest benefits in terms of kidney protection may be achieved by early initiation of SGLT2i in people with preserved eGFR. Greatest risk reduction for HF outcomes is observed in people with lower eGFR values (Diabetes, Obesity and Metabolism)
The real-world safety profile of sodium-glucose co-transporter-2 inhibitors among older adults (≥ 75 years): a retrospective, pharmacovigilance study
In this global post-marketing study, none of the adverse events was reported more frequently among older adults. Our findings provide reassurance regarding SGLT2i treatment in older adults, although careful monitoring is warranted (Cardiovascular Diabetology)
Efficacy of Dapagliflozin by Baseline Diabetes Medications: A Prespecified Analysis From the DAPA-CKD Study
Dapagliflozin reduced kidney and cardiovascular events in patients with type 2 diabetes and CKD across baseline GLT class or classes in combination (Diabetes Care)
Baseline eGFR, albuminuria and renal outcomes in patients with SGLT2 inhibitor treatment: an updated meta-analysis
Generally, the use of SGLT2i was consistently associated with decreased risk of renal events in all prespecified eGFR and albuminuria spectrums, even in patients with substantial renal impairment (Acta Diabetologica)
Impact of sodium-glucose cotransporter-2 inhibitors on heart failure and mortality in patients with cancer
The use of SGLT2i was associated with a lower rate of incident HF and prolonged overall survival in patients with cancer with diabetes mellitus (Heart Journal)
Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials
In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function (The Lancet)
Novel antihyperglycaemic drugs and prevention of chronic obstructive pulmonary disease exacerbations among patients with type 2 diabetes: population based cohort study
In this population based study, GLP-1 receptor agonists and SGLT-2 inhibitors were associated with a reduced risk of severe exacerbations compared with sulfonylureas in patients with chronic obstructive pulmonary disease and type 2 diabetes. DPP-4 inhibitors were not clearly associated with a decreased risk of chronic obstructive pulmonary disease exacerbations (BMJ)
Clinical and Safety Outcomes with GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type 1 Diabetes: A Real-World Study
GLP-1RA and SGLT2i use in T1DM is associated with clinically relevant benefits. DKA remains a clinical concern with SGLT2i use, requiring careful patient selection and monitoring, with the risk to benefit ratio of treatment evaluated at an individual level (Journal of Clinical Endocrinology & Metabolism)
Sodium–glucose co-transporter-2 (SGLT2) inhibitors in type 2 diabetes: are clinical trial benefits for heart failure reflected in real-world clinical practice? A systematic review and meta-analysis of observational studies
Real-world SGLT2 inhibitor use support randomised trial data for the size effect of reduced hospitalisation for heart failure in type 2 diabetes, although with a much lower ARR in people without CVD (Diabetes, Obesity and Metabolism)
Sodium–Glucose Cotransporter 2 Inhibitors and the Short-term Risk of Bladder Cancer: An International Multisite Cohort Study
Contrary to previous randomized controlled trials, these findings indicate that the use of SGLT2 inhibitors is not associated with an increased risk of bladder cancer compared with GLP-1RAs or DPP-4 inhibitors. This should provide reassurance on the short-term effects of SGLT2 inhibitors on bladder cancer incidence (Diabetes Care)
Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)
Consensus statements provide specific guidance on use of renin-angiotensin system inhibitors, metformin, sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineralocorticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD (Diabetes Care)
Characteristics of new users of recent antidiabetic drugs in Canada and the United Kingdom
Although SGLT-2i, DPP-4i, and GLP-1 RAs are recommended as 2nd or 3rd line therapy for type 2 diabetes, important differences exist in the characteristics of users of these drugs. Contrary to existing guidelines, new users of DPP-4i had a higher prevalence of cardiovascular disease at baseline than new users of SGLT2i or GLP-1RA (BMC Endocrine Disorders)
De-intensification of basal-bolus insulin regimen after initiation of a GLP-1 RA improves glycaemic control and promotes weight loss in subjects with type 2 diabetes
Replacing prandial insulin with GLP-1 RA is a valuable strategy to simplify the BB insulin regimen while improving glycaemic control and promoting weight loss in subjects with T2D (Acta Diabetologica)
Obesity as a modifier of the Cardiovascular effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors in Type 2 Diabetes
Compared with DPP-4i, the cardioprotective effect associated with SGLT2i is stronger among patients with higher BMI (Diabetes Research and Clinical Practice)
Real-World Treatment Patterns of Glucose-Lowering Agents Among Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease or At Risk for Cardiovascular Disease
Although use of SGLT-2is and GLP-1 RAs increased over time, overall utilization of these agents in patients with T2D and ASCVD/HF or at risk for ASCVD/HF remained low, especially for those aged ≥ 65 years (Diabetes Therapy)
Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia (Circulation)
Large Effect Size in Composite Kidney Outcomes than in Majors Cardiovascular Events of SGLT2 inhibitors compared with GLP-1 RAs: A Pooled Analysis of Type 2 Diabetes Trials
In T2D patients, treatment effect sizes were greater for kidney than for macrovascular (MACE-3) outcomes, with important differences according to the drugs considered. CKO and MACE-3 are independent. Caution must be taken when interpreting CKO in the absence of MACE-3 data (Diabetes, Obesity and Metabolism)
Sodium–Glucose Cotransporter 2 Inhibitors in Cardiovascular and Renal Outcomes in Patients With Diabetes but Without Established Cardiovascular Disease: A Nationwide Population-Based Cohort Study
Our study provided clinical evidence that the cardiovascular and renoprotective benefits of SGLT2 inhibitors could be consistently extended to primary prevention strategies among patients with diabetes with low cardiovascular risk (Diabetes Care)
Contemporary use of SGLT2 inhibitors in heart failure patients with diabetes mellitus: a comparison of DPP4 inhibitors in a nationwide electric health database of the superaged society
The use of SGLT2 inhibitors at discharge was associated with a lower risk of one-year mortality and HF readmission in patients across a broad spectrum of HF with DM in the superaged society. The findings further support the benefits of using SGLT2 inhibitors in very elderly HF care and complement the current evidence (Cardiovascular Diabetology)
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