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)
Diabetes News
Tag: SGLT2 inhibitors
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)
SGLT2 inhibitors in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials balancing their risks and benefits
Our study is limited to aggregate data. In a population of individuals with type 2 diabetes and a high CVD risk, the cardiovascular and renal benefits of SGLT2i remain substantial despite the risk of DKA and even the hypothetical risk of amputation (Diabetologia)
Re-examining the widespread policy of stopping SGLT2 inhibitors during acute illness: A perspective based on the updated evidence
Recent data suggest potential beneficial effects of SGLT2 inhibitors in the setting of acute illness with COVID-19 with no increase in adverse events and low rates of DKA which were non-severe (Diabetes, Obesity and Metabolism)
Sodium-Glucose Cotransporter 2 Inhibitor Use Among Individuals Age <65 with Type 2 Diabetes and Heart Failure with Reduced Ejection Fraction: A Cost–Benefit Analysis
SGLT-2i utilization has steadily increased, with lower HF hospitalization rates observed among SGLT-2i users. Societal benefits of SGLT-2i use in this population are substantive; payer benefits are negative unless SGLT-2i cost is drastically reduced (ClinicoEconomics and Outcomes Research)
Clinical Utility of Cardiovascular Risk Scores for Identification of People With Type 2 Diabetes More Likely to Benefit From Either GLP-1 Receptor Agonist or SGLT2 Inhibitor Therapy
A greater increase in the rate of HHF relative to MACE was observed with progressively higher cardiovascular risk, regardless of the risk score applied. Consequently, SGLT2is may offer greater overall cardiovascular protection in those at highest MACE risk, not just those at highest HHF risk (Diabetes Care)
Putative protective effects of sodium-glucose cotransporter 2 inhibitors on atrial fibrillation through risk factor modulation and off-target actions: potential mechanisms and future directions
This review discusses the SGLT2 and its role in glucose homeostasis, molecules inhibiting the transporter, possible physiological mechanisms responsible for the decreased incident atrial fibrillation in patients treated with SGLT2 inhibitors and proposes mechanistic studies to further our understanding of the biological processes involved (Cardiovascular Diabetology)
Benefits of SGLT2i for the Treatment of Heart Failure Irrespective of Diabetes Diagnosis: A State-of-the-Art Review
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)
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)
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)
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)
Impact of short-term glycemic variability on risk of all-cause mortality in type 2 diabetes patients with well-controlled glucose profile by continuous glucose monitoring: a prospective cohort study
Greater %CV was associated with increased risk for all-cause mortality even among patients with seemingly well-controlled glucose status (Diabetes Research and Clinical 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)
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