Cardiovascular, renal and liver protection with novel antidiabetic agents beyond blood glucose lowering in type 2 diabetes: consensus article from the European Society of Hypertension Working Group on Obesity, Diabetes and the High-risk Patient

The prevalence of type 2 diabetes (T2D) has increased over the past few decades. T2D has a strong genetic propensity that becomes overt when a patient is exposed to a typical Western lifestyle, gain weight and becomes obese, whereas weight loss protects from the development of T2D. Except of lifestyle modifications, the choice of the appropriate treatment is essential in the management of patients with T2D and appears critical for the obese population with T2D. The new pharmacological approach for the treatment of T2D, sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists, seems to be effective not only in the management of T2D but also for weight loss, reduction of blood pressure and improvement of nonalcoholic fatty liver disease. Sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 analogues reduced cardiovascular risk, prevented cardiovascular disease and mortality, thereby playing an important role in the treatment of obese patients with hypertension and T2D.
Source: Journal of Hypertension - Category: Cardiology Tags: CONSENSUS AND META-ANALYSES Source Type: research

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Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are worldwide public health problems, affecting up to 25 –30% (NAFLD), and up to 10–15% (CKD) of the general population. Recently, it has also been established that there is a strong association between NAFLD and CKD, regardless of the presence of potential confounding diseases such as obesity, hypertension and type 2 diabetes. Since NAFLD and CKD are both common diseases that often occur alongside other metabolic conditions, such as type 2 diabetes or metabolic syndrome, elucidating the relative impact of NAFLD on the risk of incident C...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Review Source Type: research
DiscussionThis overview will assess current evidence from systematic reviews for the association between cadmium exposure and risk of T2DM and other metabolic morbidities. This overview may be helpful for policy-makers and healthcare teams aiming to mitigate T2DM risk in populations at risk of cadmium exposure.Systematic review registrationPROSPERO CRD42019125956
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
ConclusionsConsistent with existing clinical practice guidelines, which recommend lifestyle intervention and treatment for comorbidities related to fatty liver disease as first-line treatment, trial evidence supports the efficacy of some diabetes drugs (especially pioglitazone) in patients with NAFLD or NASH, though weight gain with some diabetes drugs may warrant caution. Larger trials are needed to better characterize the efficacy and harms of diabetes pharmacotherapy in these patients.
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
AbstractPurpose of ReviewThis review will focus on the long-term outcomes in offspring exposed to in utero hyperglycemia and gestational diabetes (GDM), including obesity, adiposity, glucose metabolism, hypertension, hyperlipidemia, nonalcoholic fatty liver disease, and puberty.Recent FindingsThere is evidence, mostly from observational studies, that offspring of GDM mothers have increased risk of obesity, increased adiposity, disorders of glucose metabolism (insulin resistance and type 2 diabetes), and hypertension. In contrast, evidence from the two intervention studies of treatment of mild GDM and childhood measures of ...
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research
Metabolic syndrome, characterized by central obesity, hypertension, and hyperlipidemia, increases the morbidity and mortality of cardiovascular disease, type 2 diabetes, nonalcoholic fatty liver disease, and other metabolic diseases. It is well known that insulin resistance, especially hepatic insulin resistance, is a risk factor for metabolic syndrome. Current research has shown that hepatic fatty acid accumulation can cause hepatic insulin resistance through increased gluconeogenesis, lipogenesis, chronic inflammation, oxidative stress and endoplasmic reticulum stress, and impaired insulin signal pathway. Mitochondria ar...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Non-alcoholic fatty liver disease (NAFLD) is a growing challenge to global public health. It is defined as the increased accumulation of hepatic triglyceride (>5%) in the absence of excessive alcohol consumption or other causes of liver disease. The NAFLD spectrum encompasses steatosis (non-alcoholic fatty liver, NAFL) and non-alcoholic steatohepatitis (NASH), an inflammatory form of the condition marked by the presence of hepatocyte damage and progressive fibrosis that may lead to cirrhosis.[1,2] Although NAFLD may occur in patients with normal weight, it is closely associated with the presence of the metabolic syndrom...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
no De Lorenzo Lifestyle interventions remain the first-line treatment for non-alcoholic fatty liver disease (NAFLD), even if the optimal alimentary regimen is still controversial. The interest in antioxidants has increased over time, and literature reports an inverse association between nutrients rich in antioxidants and the risk of mortality due to non-communicable diseases, including NAFLD. Mediterranean diet (MD) is a model characterized by main consumption of plant-based foods and fish and reduced consumption of meat and dairy products. MD represents the gold standard in preventive medicine, probably due to the har...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
The objective of the present study was to investigate the association between hair and urine Al levels and obesity.MethodsA total of 206 lean and 205 obese non-occupationally exposed subjects (30-50 y.o.) were enrolled in the study. Hair and urine Al levels were assessed with ICP-MS. Laboratory quality control was performed using the certified reference materials of human hair, plasma, and urine.ResultsHair and urinary Al levels in obese subjects were significantly higher by 31% and 46% compared to the control levels, respectively. The presence of hypertension (41% cases), atherosclerosis (8%), type 2 diabetes melli...
Source: Journal of Trace Elements in Medicine and Biology - Category: Biochemistry Source Type: research
Publication date: Available online 24 July 2019Source: Archives of Cardiovascular Diseases SupplementsAuthor(s): Imen Sebai, Ibtissem Oueslati, Emna Talbi, Emna El Feleh, Wafa Grira, Meriem Yazidi, Fatma Chaker, Melika ChihaouiAimsNon-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in type 2 diabetes mellitus (T2DM). In addition to its liver complications, it is associated with increased cardiovascular risk. The aim of our work was to assess the relationship between NAFLD and cardiovascular disease risk (CVDR) in a group of patients with T2DM.MethodsThis was a cross-sectional study conducted ...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
This study aims to determine the effect of type 2 diabetes mellitus and insulin therapy on non-alcoholic fatty liver disease in the patients with morbid obesity. MATERIAL AND METHODS: Clinical, anthropometric and laboratory data were analyzed together with intraoperative liver biopsies from morbidly obese patients undergoing bariatric surgery. RESULTS: 219 patients with morbid obesity were evaluated. Systemic arterial hypertension (55.9% vs. 33.8%, p = 0.004) and dyslipidemia (67.1% vs. 39.0%, p
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
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