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Comparative Effects of Sodium-Glucose Cotransporter 2 Inhibitor and Thiazolidinedione Treatment on Risk of Stroke among Patients with Type 2 Diabetes Mellitus
CONCLUSION: In this real-world data, the risk of stroke was comparable in T2DM patients treated with SGLT-2i or TZD.PMID:35130688 | DOI:10.4093/dmj.2021.0160
Source: Diabetes and Metabolism Journal - February 8, 2022 Category: Endocrinology Authors: Seung Eun Lee Hyewon Nam Han Seok Choi Hoseob Kim Dae-Sung Kyoung Kyoung-Ah Kim Source Type: research

SGLT2 inhibitors: Effect on myocardial infarction and stroke in type 2 diabetes
J Clin Endocrinol Metab. 2023 Feb 28:dgad113. doi: 10.1210/clinem/dgad113. Online ahead of print.ABSTRACTBACKGROUND: SGLT2 inhibitors (sodium-glucose cotransporter-2 inhibitors) have recently been recommended as preferred agents for management of hyperglycemia in type 2 diabetes, primarily based on their ability to reduce a composite of major cardiovascular adverse events (3P MACE), predominantly by reducing cardiovascular death. However reduction of the individual components, myocardial infarction (MI) or stroke (fatal and non-fatal) events have not been well explored.METHODS: In this meta-analysis, we included data avail...
Source: The Journal of Clinical Endocrinology and Metabolism - March 1, 2023 Category: Endocrinology Authors: Pradip Mukhopadhyay Debmalya Sanyal Purushottam Chatterjee Kaushik Pandit Sujoy Ghosh Source Type: research

Do SGLT2 inhibitors and GLP-1 receptor agonists modulate differently the risk of stroke ? Discordance between randomised controlled trials and observational studies
Diabetes Metab. 2023 Sep 5:101474. doi: 10.1016/j.diabet.2023.101474. Online ahead of print.ABSTRACTStroke represents a major burden in patients with type 2 diabetes, yet this cerebrovascular complication has been less carefully investigated than the risk of cardiovascular mortality, heart failure and renal disease. Some data suggested that glucagon peptide-1 receptor agonists (GLP-1RAs) exert a better protection against stroke than sodium-glucose cotransporter 2 inhibitors (SGLT2is). However, this conclusion was derived from indirect comparisons in absence of any head-to-head randomised controlled trial (RCT). The present...
Source: Diabetes and Metabolism - September 7, 2023 Category: Endocrinology Authors: Andr é J Scheen Source Type: research

Association of glucose-lowering medications with cardiovascular outcomes: an umbrella review and evidence map
We examined the association between glucose-lowering medications and a broad range of cardiovascular outcomes, and assessed the strength of evidence for these associations.MethodsFor this umbrella review we searched PubMed, Embase, and the Cochrane Library to identify systematic reviews and meta-analyses of randomised controlled trials examining the cardiovascular safety of glucose-lowering medications. Cardiovascular outcomes examined included major adverse cardiovascular events, cardiovascular death, myocardial infarction, stroke, heart failure, unstable angina, and atrial fibrillation. For each meta-analysis, we estimat...
Source: The Lancet Diabetes and Endocrinology - January 30, 2020 Category: Endocrinology Source Type: research

Antidiabetic agents and risk of atrial fibrillation/flutter: a comparative critical analysis with a focus on differences between SGLT2 inhibitors and GLP-1 receptor agonists
Diabetes Metab. 2022 Sep 25:101390. doi: 10.1016/j.diabet.2022.101390. Online ahead of print.ABSTRACTAtrial fibrillation/flutter (AF/AFL) is a common cardiac arrhythmia in patients with diabetes and is associated with an increased risk of morbidity, including ischaemic stroke and heart failure, and mortality. Different classes of glucose-lowering agents have shown distinct effects on the risk of stroke and heart failure. Their effects on cardiac arrhythmias such as AF/AFL have not been carefully investigated yet and even less their possible relationship with classical complications such as stroke and heart failure. The pre...
Source: Diabetes and Metabolism - September 28, 2022 Category: Endocrinology Authors: Andr é J Scheen Source Type: research

GLP-1RAs and SGLT2is Reduce Cardiovascular Events Independent of Reductions of Systolic Blood Pressure and Body Weight: A Meta-Analysis with Meta-Regression
ConclusionsGLP-1RAs and SGLT2is lead to similar benefits on MACE, CVD, MI, and ACD in adults with type  2 diabetes. The benefit from SGLT2is on HHF is greater than that from GLP-1RAs, while GLP-1RAs vs. placebo significantly reduce stroke whereas SGLT2is do not. The two drug classes reduce cardiovascular events independent of reductions of systolic blood pressure and body weight.
Source: Diabetes Therapy - September 23, 2020 Category: Endocrinology Source Type: research

Cardiovascular mortality and morbidity in patients with type 2 diabetes following initiation of sodium-glucose co-transporter-2 inhibitors versus other glucose-lowering drugs (CVD-REAL Nordic): a multinational observational analysis
Publication date: Available online 3 August 2017 Source:The Lancet Diabetes & Endocrinology Author(s): Kåre I Birkeland, Marit E Jørgensen, Bendix Carstensen, Frederik Persson, Hanne L Gulseth, Marcus Thuresson, Peter Fenici, David Nathanson, Thomas Nyström, Jan W Eriksson, Johan Bodegård, Anna Norhammar Background In patients with type 2 diabetes and a high cardiovascular risk profile, the sodium-glucose co-transporter-2 (SGLT2) inhibitors empagliflozin and canagliflozin have been shown to lower cardiovascular morbidity and mortality. Using real-world data from clinical practice, we aimed to compare cardiovas...
Source: The Lancet Diabetes and Endocrinology - August 4, 2017 Category: Endocrinology Source Type: research

Incidence of adverse cardiovascular events in type 2 diabetes mellitus patients after initiation of the glucose ‐lowering agents: A population‐based community study from the Shizuoka Kokuho Database
ConclusionsThe incidence of HHF was similar to that of stroke. Significant portion of our cohort met the inclusion criteria for major randomized clinical trials for SGLT2i, and estimated reduction in the HHF events was substantial.
Source: Journal of Diabetes Investigation - December 21, 2020 Category: Endocrinology Authors: Shun Kohsaka, Hiraku Kumamaru, Shiori Nishimura, Satoshi Shoji, Eiji Nakatani, Nao Ichihara, Hiroyuki Yamamoto, Yoshiki Miyachi, Hiroaki Miyata Tags: ORIGINAL ARTICLE Source Type: research

The efficacy and safety of novel classes of glucose-lowering drugs for cardiovascular outcomes: a network meta-analysis of randomised clinical trials
Conclusions/interpretationSGLT2i and GLP-1RA are superior to DPP-4i in terms of CV and renal outcomes. GLP-1RA is the only drug class that reduces the risk of stroke. SGLT2i is superior in reducing HHF and renal outcomes. Therefore, the choice between SGLT2i and GLP-1RA should be individualised according to patient profiles.PROSPERO registration number: CRD42020206600.Graphical abstract
Source: Diabetologia - November 2, 2021 Category: Endocrinology Source Type: research

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