Early combination therapy with two and sometimes three of the DMDs (SGLT2i and GLP-1 RA) and metformin, and lower HbA1c targets (< 6.5%), may halt and even regress the pathological basis of diabetes and improve patient’s prognosis (Cardiovascular Diabetology)
Diabetes News
Tag: SGLT2 inhibitors
All Wales Advice on SGLT-2 Inhibitors in Type 2 Diabetes and Cardiovascular Disease
Consultation
Cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors in diabetic and nondiabetic patients
In this review, we focus mainly on the cardiovascular benefits of SGLT2i, the underlying mechanisms, and prospects for clinical application (Cardiovascular Diabetology)
Effect of sodium–glucose co-transporter-2 inhibitors on the levels of serum asprosin in patients with newly diagnosed type 2 diabetes mellitus
These findings indicated that SGLT2 inhibitors can lower serum asprosin levels and improve glucolipid and weight in patients with newly diagnosed T2DM, which may benefit the cardiovascular system (Diabetology & Metabolic Syndrome)
Cardiorenal and other diabetes related outcomes with SGLT-2 inhibitors compared to GLP-1 receptor agonists in type 2 diabetes: nationwide observational study
This observational study suggests that treatment with GLP-1RA and SGLT-2i result in very similar cardiorenal outcomes. In the short term, treatment with GLP-1RA seem to be associated with lower risks of stroke and peripheral artery disease, whereas SGLT-2i seem to be nominally associated with lower risk of heart failure and total mortality (Cardiovascular Diabetology)
Meta-analyses of Results From Randomized Outcome Trials Comparing Cardiovascular Effects of SGLT2is and GLP-1RAs in Asian Versus White Patients With and Without Type 2 Diabetes
Compared with Whites, Asians may derive greater CV death/HHF benefit from SGLT2is in patients with HFrEF, and MACE benefit from GLP-1RAs in patients with type 2 diabetes (Diabetes Care)
GLP-1 receptor agonists and SGLT2 inhibitors for older people with type 2 diabetes: A systematic review and meta-analysis
In older adults with diabetes, GLP-1 RAs reduced MACE and its components. SGLT2 inhibitors reduced MACE, and heart failure and renal outcomes (Diabetes Research and Clinical Practice)
Sodium–Glucose Co-Transporter 2 Inhibitors (SGLT2i) Exposure and Outcomes in Type 2 Diabetes: A Systematic Review of Population-Based Observational Studies
In T2D, SGLT2is appear safe from the CV perspective and may have associated benefit in primary as well as secondary CVD prevention. For safety, they may be associated with an increased risk of GMI, LLA and DKA, although longer follow-up studies are needed (Diabetes Therapy)
Trends in diabetes medication use in Australia, Canada, England, and Scotland: a repeated cross-sectional analysis in primary care
New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s (British Journal of General Practice)
SGLT2 Inhibition Does Not Affect Myocardial Fatty Acid Oxidation or Uptake, but Reduces Myocardial Glucose Uptake and Blood Flow in Individuals With Type 2 Diabetes
SGLT2 inhibition does not affect myocardial FFA oxidation or uptake, but induces a shift in myocardial substrate utilization from glucose toward other sources, possibly ketone bodies. However, this shift in myocardial substrate utilization is quantitatively of minor importance and does not appear to improve either MEE or myocardial oxygen consumption. Therefore, it is unlikely to explain the striking cardioprotective benefit of SGLT2 inhibition. Of interest, SGLT2 inhibition reduces resting MBF, even when adjusting for cardiac workload (Diabetes)
Changes in Cardiovascular Biomarkers Associated With the Sodium–Glucose Cotransporter 2 (SGLT2) Inhibitor Ertugliflozin in Patients With Chronic Kidney Disease and Type 2 Diabetes
The effects of ertugliflozin on natriuretic peptides and neurohormones are preserved in patients with moderate CKD and consistent with plasma volume reduction. The rise in HCT without a change in erythropoiesis supports the volume contraction mechanism of SGLT2 inhibitor therapy. These effects may be important physiologically and contribute to a lower risk of CVD with SGLT2 inhibitor treatment in people with type 2 diabetes (Diabetes Care)
SGLT-2 inhibitors and atrial fibrillation in the Food and Drug Administration adverse event reporting system
In a large pharmacovigilance database, AF was robustly and consistently reported more frequently for diabetes medications other than SGLT2i. This finding complements available evidence from trials supporting a protective role of SGLT2i against the occurrence of AF (Cardiovascular Diabetology)
Sodium–glucose cotransporter 2 inhibitors reduce day‐to‐day glucose variability in patients with type 1 diabetes
SGLT2i improved day‐to‐day glucose variability and time in the target glucose range, without increasing frequency of hypoglycemia, in patients with type 1 diabetes, and reduced glycated hemoglobin, body mass and the required insulin dose (Journal of Diabetes Investigation)
Sodium–glucose cotransporter 2 inhibitor‐induced reduction in the mean arterial pressure improved renal composite outcomes in type 2 diabetes mellitus patients with chronic kidney disease: A propensity score‐matched model analysis in Japan
The degree of blood pressure reduction after SGLT2 inhibitor treatment influenced renal composite outcomes in Japanese type 2 diabetes mellitus patients with CKD, confirming the importance of blood pressure management in type 2 diabetes mellitus patients with CKD, even when they are under SGLT2 inhibitor treatment (Journal of Diabetes Investigation)
Glucosuric, renal and hemodynamic effects of a dual inhibitor of SGLT1 and SGLT2, licogliflozin, in patients with chronic kidney disease: a randomized trial
Licogliflozin treatment results in significantly increased UGE and favorable changes in urinary electrolytes and hemodynamics in patients with varying degrees of CKD (eGFR≥45 mL/min/1.73 m2) (Diabetes, Obesity and Metabolism)
Effect of sodium–glucose cotransporter 2 inhibitors on cardiac structure and function in type 2 diabetes mellitus patients with or without chronic heart failure: a meta-analysis
The use of SGLT2i was associated with significant improvements in cardiac diastolic function, plasma NT-proBNP level, and the KCCQ score in T2DM patients with or without chronic HF, but did not significantly affect cardiac structural parameters indexed by body surface area. The LVEF level was improved only in HF patients with reduced ejection fraction (Cardiovascular Diabetology)
Use of Metformin and Cardiovascular Effects of New Classes of Glucose-Lowering Agents: A Meta-analysis of Cardiovascular Outcome Trials in Type 2 Diabetes
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)
Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials
In patients with type 2 diabetes, SGLT-2 inhibitors and GLP-1 receptor agonists reduced cardiovascular and renal outcomes, with notable differences in benefits and harms (BMJ)
SGLT2 inhibitors in type 2 diabetic patients with renal function impairment slows the annual renal function decline, in a real clinical practice
SGLT2is administration slows the decline observed in the annual renal function in T2DM patients with eGFR of < 60 ml/min/1.73m2, in clinical practice (Journal of Diabetes Investigation)
Sodium–glucose transporter-2 inhibitors for prevention and treatment of cardiorenal complications of type 2 diabetes
This review summarizes work in the area of sodium–glucose cotransporter 2 inhibitors (SGLT-2i) treatment and prevention of cardiorenal complications in patients with T2D (major adverse cardiovascular events, hospitalization for heart failure, kidney outcomes), with a particular emphasis on the effect of age, the role of primary versus secondary prevention and the possible extension of their cardiorenal benefits to the entire class of SGLT-2i (Cardiovascular Diabetology)
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