Type 2 Diabetes and Thiazide Diuretics

AbstractPurpose of ReviewIn patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes.Recent FindingsThese metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents.SummaryBenefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension.
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research

Related Links:

AbstractDespite an enormous improvement in heart failure management during the last decades, the hospitalization and mortality rate of heart failure patients still remain very high. Clinical inertia, defined as the lack of treatment intensification in a patient not at evidence-based goals for care, is an important underlying cause. Clinical inertia is extensively described in hypertension and type 2 diabetes mellitus, but increasingly recognized in heart failure as well. Given the well-established guidelines for the management of heart failure, these are still not being reflected in clinical practice. While the absolute ma...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
AbstractThe heart failure (HF) epidemic is growing and approximately half of the HF patients have heart failure with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous syndrome, characterized by a preserved left ventricular ejection fraction (LVEF ≥ 50%) with diastolic dysfunction, and is associated with high morbidity and mortality. Underlying comorbidities of HFpEF, i.e., hypertension, type 2 diabetes mellitus, obesity, and renal failure, lead to a systemic pro-inflammatory state, thereby affecting normal cardiac function. Increased inf lammatory biomarkers predict incident HFpEF and are higher in pa...
Source: Journal of Cardiovascular Translational Research - Category: Cardiology Source Type: research
This study provides direct evidence for the contribution of gut microbiota to the cognitive decline during normal aging and suggests that restoring microbiota homeostasis in the elderly may improve cognitive function. On Nutraceutical Senolytics https://www.fightaging.org/archives/2020/05/on-nutraceutical-senolytics/ Nutraceuticals are compounds derived from foods, usually plants. In principle one can find useful therapies in the natural world, taking the approach of identifying interesting molecules and refining them to a greater potency than naturally occurs in order to produce a usefully large therape...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSION: Epidemiological, experimental, and clinical studies permit us to affirm that regular physical activity improves immunomodulation and may play a key role in the prevention and treatment of several age-related chronic diseases. However, further studies are needed to better describe the prophylactic and therapeutic effects of physical exercise in specific organs of older individuals, as well as the mechanisms involved in such response. PMID: 32396868 [PubMed - as supplied by publisher]
Source: Journal of Physical Activity and Health - Category: Sports Medicine Tags: J Phys Act Health Source Type: research
Abstract Human health and environmental risks are increasing following air pollution associated with vehicular and industrial emissions in which particulate matter is a constituent. The purpose of this review was to assess studies on the health effects and mortality induced by particles published for the last 15 years. The literature survey indicated the existence of strong positive associations between fine and ultrafine particles' exposure and cardiovascular, hypertension, obesity and type 2 diabetes mellitus, cancer health risks, and mortality. Its exposure is also associated with increased odds of hypertensive...
Source: Environmental Science and Pollution Research International - Category: Environmental Health Authors: Tags: Environ Sci Pollut Res Int Source Type: research
Abstract BACKGROUND: Type 2 diabetes (T2D) and resistant hypertension (rHT) often coexist, greatly increasing risk of target-organ damage and death. We explored the effects of empagliflozin in patients with and without presumed resistant hypertension (prHT) in a post hoc analysis of EMPA-REG OUTCOME (NCT01131676). METHODS: Overall, 7020 patients received empagliflozin 10mg, 25mg, or placebo with median follow-up of 3.1 years. We defined baseline prHT as ≥3 classes of antihypertensive drugs including a diuretic and uncontrolled BP (SBP≥140 and/or diastolic BP [DBP]≥90 mmHg), or ≥4 classes of antihy...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research
Authors: Herat LY, Matthews VB, Magno AL, Kiuchi MG, Carnagarin R, Schlaich MP Abstract Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors such as Empagliflozin are novel antihyperglycemic drugs approved for the treatment of type 2 diabetes (T2D). In addition to its glucose-lowering effects, Empagliflozin promotes weight loss, blood pressure reduction, and other beneficial metabolic benefits.Areas covered: This review outlines the pharmacokinetics, pharmacodynamics, safety, and tolerability of Empagliflozin and discusses its role in diabetes-associated hypertension.Expert opinion: Empagliflozin was the...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
Obesity is a serious, chronic, treatable, and global disease epidemic. Over 98 million people currently have the disease of obesity, and in a recent New England Journal of Medicine article, Harvard researchers predicted that by 2030, 50% of the population in the United States will have the disease of obesity. Type 2 diabetes (T2D) is significantly associated with obesity. While many people with obesity do not have diabetes, most people with T2D have the disease of obesity. Excess adiposity (body fat storage), which is present in obesity, contributes to many chronic diseases beyond T2D. These include high blood pressure, he...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diabetes Diet and Weight Loss Health Heart Health Surgery Source Type: blogs
This study aims to investigate the plasma and saliva levels of U-II at diagnosis and after 3-month metformin treatment in recently diagnosed Type 2 DM patients and compare these levels to those of healthy volunteers. METHODS: Our study compared 30 recently diagnosed Type 2 DM patients to their states after 3-month metformin treatment and 30 healthy volunteers. RESULTS: When compared with the control group, there was no significant increase in the plasma and saliva U-II levels of recently diagnosed Type 2 DM patients. We determined a statistically significant increase in the plasma and saliva ureotensin-2 levels o...
Source: Endokrynologia Polska - Category: Endocrinology Authors: Tags: Endokrynol Pol Source Type: research
Pulmonary arterial hypertension (PAH) is characterised by progressive obliteration of the pulmonary vasculature, culminating in right-sided heart failure (HF). In recent years, studies have observed an association between systemic metabolic dysfunction, PAH and right ventricular failure [1]. Patients with PAH have an increased prevalence of obesity [2] and type 2 diabetes [3, 4]. Interestingly, abnormal glucose metabolism is evident even in non-diabetic individuals with PAH [5–7], and serves as an independent predictor of prognosis [8].
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research
More News: Cardiology | Cardiovascular | Diabetes | Diabetes Type 2 | Endocrinology | Heart | Heart Failure | Hydrochlorothiazide | Hypertension | Indapamide | Study