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First-Line Therapy for Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists : A Cost-Effectiveness Study
CONCLUSION: As first-line agents, SGLT2 inhibitors and GLP1 receptor agonists would improve type 2 diabetes outcomes, but their costs would need to fall by at least 70% to be cost-effective.PRIMARY FUNDING SOURCE: American Diabetes Association.PMID:36191315 | DOI:10.7326/M21-2941
Source: Annals of Internal Medicine - October 3, 2022 Category: Internal Medicine Authors: Jin G Choi Aaron N Winn M Reza Skandari Melissa I Franco Erin M Staab Jason Alexander Wen Wan Mengqi Zhu Elbert S Huang Louis Philipson Neda Laiteerapong Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

Alpha-glucosidase inhibitors for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus.
CONCLUSIONS: AGI may prevent or delay the development of T2DM in people with IGT. There is no firm evidence that AGI have a beneficial effect on cardiovascular mortality or cardiovascular events. PMID: 30592787 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 28, 2018 Category: General Medicine Authors: Moelands SV, Lucassen PL, Akkermans RP, De Grauw WJ, Van de Laar FA Tags: Cochrane Database Syst Rev Source Type: research

Dipeptidyl-peptidase (DPP)-4 inhibitors and glucagon-like peptide (GLP)-1 analogues for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk for the development of type 2 diabetes mellitus.
CONCLUSIONS: There is no firm evidence that DPP-4 inhibitors or GLP-1 analogues compared mainly with placebo substantially influence the risk of T2DM and especially its associated complications in people at increased risk for the development of T2DM. Most trials did not investigate patient-important outcomes. PMID: 28489279 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 10, 2017 Category: General Medicine Authors: Hemmingsen B, Sonne DP, Metzendorf MI, Richter B Tags: Cochrane Database Syst Rev Source Type: research

Impact of bromocriptine-QR therapy on cardiovascular outcomes in type 2 diabetes mellitus subjects on metformin.
CONCLUSION: These findings suggest that in T2DM subjects on metformin, BQR therapy may represent an effective strategy for reducing CVD risk. PMID: 27687032 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - October 2, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Cardiovascular safety of glucose ‐lowering agents as add‐on medication to metformin treatment in type 2 diabetes: report from the Swedish National Diabetes Register
ConclusionsThis nationwide observational study showed that second‐line treatment with TZD and DPP‐4 inhibitor as add‐on medication to metformin were associated with significantly lower risks of mortality and cardiovascular events compared with SU, whereas basal insulin was associated with a higher risk of mortality.
Source: Diabetes, Obesity and Metabolism - July 18, 2016 Category: Endocrinology Authors: Nils Ekstr öm, Ann‐Marie Svensson, Mervete Miftaraj, Stefan Franzén, Björn Zethelius, Björn Eliasson, Soffia Gudbjörnsdottir Tags: ORIGINAL ARTICLE Source Type: research

Cardiovascular Safety of Glucose‐Lowering Agents as Add‐on Medication to Metformin Treatment in Type 2 Diabetes:Report from the Swedish National Diabetes Register (NDR)
Conclusions: This nationwide observational study showed that second‐line treatment with TZD and DPP‐4i as add‐on medication to metformin were associated with significantly lower risks of mortality and cardiovascular events compared with SU, whereas basal insulin was associated with a higher risk of mortality.
Source: Diabetes, Obesity and Metabolism - May 31, 2016 Category: Endocrinology Authors: Nils Ekström, Ann‐Marie Svensson, Mervete Miftaraj, Stefan Franzén, Björn Zethelius, Björn Eliasson, Soffia Gudbjörnsdottir Tags: ORIGINAL ARTICLE Source Type: research

Cardiovascular risks associated with second‐line oral antidiabetic agents added to metformin in patients with Type 2 diabetes: a nationwide cohort study
ConclusionThere were no differences in overall cardiovascular risks among several add‐on second‐line oral antidiabetic agents; however, glinide plus metformin and α‐glucosidase inhibitors plus metformin combination therapies might be associated with lower risks of acute myocardial infarction.This article is protected by copyright. All rights reserved.
Source: Diabetic Medicine - May 1, 2015 Category: Endocrinology Authors: Y.‐C. Chang, L.‐M. Chuang, J.‐W. Lin, S.‐T. Chen, M.‐S. Lai, C.‐H. Chang Tags: Research Article Source Type: research

Cardiovascular Risk Associated with Acarbose versus Metformin as the First-line Treatment in Patients with Type 2 Diabetes: a Nationwide Cohort Study.
Conclusion: Our data do not support that acarbose has a cardio-protective effect similar to metformin as a first-line anti-diabetic agent. PMID: 25555040 [PubMed - as supplied by publisher]
Source: Diabetes Metab - January 2, 2015 Category: Endocrinology Authors: Chang C, Chang Y, Lin J, Chen S, Chuang L, Lai M Tags: J Clin Endocrinol Metab Source Type: research

Metformin associated with better cardiovascular outcomes than other glycaemic therapies
Context A question exists as to whether the outcome of glycaemic treatment of diabetes varies with the agent used; speculation surrounds whether metformin might be preferable to other treatments. Methods Ghotbi and colleagues performed an epidemiological analysis of 8192 obese patients with diabetes at increased cardiovascular risk participating in the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Mortality and a combined cardiovascular outcome of non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest or cardiovascular death were compared among those receiving one of the following interv...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Bloomgarden, Z. T. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Ischaemic heart disease, Diabetes, Health education, Smoking Therapeutics Source Type: research