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Repurposing Antidiabetic Drugs for Cardiovascular Disease
Metabolic diseases and diabetes represent an increasing global challenge for human health care. As associated with a strongly elevated risk of developing atherosclerosis, kidney failure and death from myocardial infarction or stroke, the treatment of diabetes requires a more effective approach than lowering blood glucose levels. This review summarizes the evidence for the cardioprotective benefits induced by antidiabetic agents, including sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP1-RA), along with sometimes conversely discussed effects of dipeptidyl peptidase-4 inhib...
Source: Frontiers in Physiology - September 14, 2020 Category: Physiology Source Type: research

Metformin monotherapy for adults with type 2 diabetes mellitus.
CONCLUSIONS: There is no clear evidence whether metformin monotherapy compared with no intervention, behaviour changing interventions or other glucose-lowering drugs influences patient-important outcomes. PMID: 32501595 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 4, 2020 Category: General Medicine Authors: Gnesin F, Thuesen ACB, Kähler LKA, Madsbad S, Hemmingsen B Tags: Cochrane Database Syst Rev Source Type: research

Budget impact analysis for dapagliflozin in type 2 diabetes in Egypt.
Conclusion: Treating T2DM patients using dapagliflozin instead of conventional medications, maximizes patient's benefits and decreases total costs due to drug cost offsets from fewer cardiovascular and renal events. The adoption of dapagliflozin is a budget-saving treatment option, resulting in substantial population-level health gains due to reduced event rate and cost savings from the perspective of the national healthcare system. PMID: 32364032 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - May 5, 2020 Category: Health Management Tags: J Med Econ Source Type: research

Exploring the Possible Impact of Unbalanced Open-Label Drop-In of Glucose-Lowering Medications on EXSCEL Outcomes.
Conclusions: EXSCEL-observed HRs for MACE and ACM remained robust after right censoring or application of literature-derived risk reductions, but the exenatide versus placebo MACE effect size and statistical significance were increased by IPTW. Effects of open-label drop-in cardioprotective medications need to be considered carefully when designing, conducting, and analyzing cardiovascular outcome trials of glucose-lowering agents under the premise of glycemic equipoise. Clinical Trial Registration: URL: https://clinicaltrials.gov Unique Identifier: NCT01144338. PMID: 32098501 [PubMed - as supplied by publisher]
Source: Circulation - February 25, 2020 Category: Cardiology Authors: Bethel MA, Stevens SR, Buse JB, Choi J, Gustavson SM, Iqbal N, Lokhnygina Y, Mentz RJ, Patel RA, Öhman P, Schernthaner G, Lecube A, Hernandez AF, Holman RR Tags: Circulation Source Type: research

GLP-1 Receptor Agonists and SGLT2 Inhibitors for the Treatment of Type 2 Diabetes: New Insights and Opportunities for Cardiovascular Protection.
Authors: Bertoccini L, Baroni MG Abstract The risk of cardiovascular disease (CVD) (myocardial infarction, stroke, peripheral vascular disease) is twice in type 2 diabetes (T2D) patients compared to non-diabetic subjects. Furthermore, cardiovascular disease (CV) is the leading cause of death in patients with T2D.In the last years several clinical intervention studies with new anti-hyperglycaemic drugs have been published, and they have shown a positive effect on the reduction of mortality and cardiovascular risk in T2D patients. In particular, these studies evaluated sodium/glucose-2 cotransporter inhibitors (SGLT2...
Source: Advances in Experimental Medicine and Biology - February 9, 2020 Category: Research Tags: Adv Exp Med Biol Source Type: research

A Multinational Real-World Study on the Clinical Characteristics of Patients with Type  2 Diabetes Initiating Dapagliflozin in Southern Europe
ConclusionsSignificant differences were seen among patients initiating dapagliflozin in southern Europe. Our results suggest that dapagliflozin was being initiated at different stages of the disease according to the country and prescribing settings. Such geographic heterogeneity may have an impact upon effectiveness of dapagliflozin on glucose lowering, as well as cardiovascular and renal outcomes.
Source: Diabetes Therapy - December 19, 2019 Category: Endocrinology Source Type: research

Metformin for prevention or delay of type 2 diabetes mellitus and its associated complications in persons at increased risk for the development of type 2 diabetes mellitus.
CONCLUSIONS: Metformin compared with placebo or diet and exercise reduced or delayed the risk of T2DM in people at increased risk for the development of T2DM (moderate-quality evidence). However, metformin compared to intensive diet and exercise did not reduce or delay the risk of T2DM (moderate-quality evidence). Likewise, the combination of metformin and intensive diet and exercise compared to intensive diet and exercise only neither showed an advantage or disadvantage regarding the development of T2DM (very low-quality evidence). Data on patient-important outcomes such as mortality, macrovascular and microvascular diabe...
Source: Cochrane Database of Systematic Reviews - December 2, 2019 Category: General Medicine Authors: Madsen KS, Chi Y, Metzendorf MI, Richter B, Hemmingsen B Tags: Cochrane Database Syst Rev Source Type: research

Metformin Use and Clinical Outcomes among Patients with Diabetes with or without Heart Failure or Kidney Dysfunction: Observations from the SAVOR-TIMI 53 Trial.
CONCLUSIONS: In a cohort of 12,156 patients with T2DM and high CV risk, metformin use was associated with lower rates of all-cause mortality, including after adjustment for clinical variables and biomarkers, but not lower rates of the composite endpoint of CV death, MI, or ischemic stroke. This association was most apparent in patients without prior HF or moderate to severe CKD. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov Unique Identifier: NCT01107886. PMID: 31362530 [PubMed - as supplied by publisher]
Source: Circulation - July 30, 2019 Category: Cardiology Authors: Bergmark BA, Bhatt DL, McGuire DK, Cahn A, Mosenzon O, Steg PG, Im K, Kanevsky E, Gurmu Y, Raz I, Braunwald E, Scirica BM, SAVOR-TIMI 53 Steering Committee and Investigators Tags: Circulation Source Type: research

Metformin: time to review its role and safety in chronic kidney disease.
Authors: Tanner C, Wang G, Liu N, Andrikopoulos S, Zajac JD, Ekinci EI Abstract ■Metformin is recommended as first-line therapy for type 2 diabetes because of its safety, low cost and potential cardiovascular benefits. ■The use of metformin was previously restricted in people with chronic kidney disease (CKD) - a condition that commonly coexists with diabetes - due to concerns over drug accumulation and metformin-associated lactic acidosis. ■There are limited data from observational studies and small randomised controlled trials to suggest that metformin, independent of its antihyperglycaemic effects, may be ...
Source: Medical Journal of Australia - June 14, 2019 Category: General Medicine Tags: Med J Aust Source Type: research

Antibiotic use linked to increased risk of heart attack and stroke in women
Risk is greatest for older women who take antibiotics for more than two months Related items fromOnMedica Withdrawn valsartan meds not linked to short-term cancer risk Cardio risk raised in people using long-acting bronchodilators Recurrent stroke more likely at very low BP Rising use of antithrombotics linked to subdural haematoma Adding insulin to metformin linked to higher mortality
Source: OnMedica Latest News - May 27, 2019 Category: UK Health Source Type: news

Liraglutide for the prevention of major adverse cardiovascular events in diabetic patients.
Authors: Madsbad S Abstract INTRODUCTION: The GLP-1 receptor agonist (GLP-1 RA) liraglutide has a half-life of approximately 13 h and is suitable for subcutaneous administration once daily. The use of liraglutide in people with type 2 diabetes has become popular because of the efficacy and durability in relation to glycemic control in combination with weight loss in most patients. Areas covered: PubMed searches were completed using the terms "GLP-1 receptor agonist", "Liraglutide", "Liraglutide and CVD", "Liraglutide and CVD risk factors". The reference list of articles subsequently identified was searched and arti...
Source: Expert Review of Cardiovascular Therapy - May 7, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Cardiovascular effects of pioglitazone or sulphonylureas according to pretreatment risk: moving towards personalized care.
CONCLUSIONS: It is possible to identify patients with type 2 diabetes early in the stage of their disease and largely free from evident cardiovascular disease, in whom add-on pioglitazone to metformin confers cardiovascular protection as compared to sulphonylureas. PMID: 31058962 [PubMed - as supplied by publisher]
Source: The Journal of Clinical Endocrinology and Metabolism - May 5, 2019 Category: Endocrinology Authors: Vaccaro O, Lucisano G, Masulli M, Bonora E, Del Prato S, Rivellese AA, Giorda CB, Mocarelli P, Squatrito S, Maggioni AP, Riccardi G, Nicolucci A, TOSCA.IT investigators Tags: J Clin Endocrinol Metab Source Type: research

Metformin and second- or third-generation sulphonylurea combination therapy for adults with type 2 diabetes mellitus.
CONCLUSIONS: There is inconclusive evidence whether M+S combination therapy compared with metformin plus another glucose-lowering intervention results in benefit or harm for most patient-important outcomes (mortality, SAEs, macrovascular and microvascular complications) with the exception of hypoglycaemia (more harm for M+S combination). No RCT reported on health-related quality of life. PMID: 30998259 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 17, 2019 Category: General Medicine Authors: Madsen KS, Kähler P, Kähler LKA, Madsbad S, Gnesin F, Metzendorf MI, Richter B, Hemmingsen B Tags: Cochrane Database Syst Rev Source Type: research

Blood Flow Restriction Exercise Attenuates the Exercise-Induced Endothelial Progenitor Cell Response in Healthy, Young Men
Conclusion In summary, this is the first study to show that BFR exercise did not augment EPC response to exercise, and in fact blunted the EPC response to low load unilateral KE exercise in young, healthy males. Ethics Statement This study was carried out in accordance with the recommendations of Edinburgh Napier University Research and Ethics Governance Committee. The study was ethically approved by Edinburgh Napier University Research and Ethics Governance Committee. All participants gave written informed consent in accordance with the Declaration of Helsinki. Author Contributions MR, RM, AP, CW, GF-J designed the s...
Source: Frontiers in Physiology - April 16, 2019 Category: Physiology Source Type: research

Daily Aspirin No Longer Recommended To Prevent Heart Attacks In Older Adults
(CNN) — If you’re a healthy older adult looking for ways to reduce your risk of heart attack and stroke, don’t turn to that age-old standby: daily low-dose aspirin. It’s no longer recommended as a preventative for older adults who don’t have a high risk or existing heart disease, according to guidelines announced Sunday by the American College of Cardiology and the American Heart Association. “For the most part, we are now much better at treating risk factors such as hypertension, diabetes and especially high cholesterol,” said North Carolina cardiologist Dr. Kevin Campbell, who wa...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - March 18, 2019 Category: Consumer Health News Authors: Health – CBS Boston Tags: Health News aspirin CNN Source Type: news

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