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Comparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes: A Systematic Review and Network Meta-analysis.
CONCLUSION: In diabetic patients at low cardiovascular risk, no treatment differs from placebo for vascular outcomes. In patients at increased cardiovascular risk receiving metformin-based background therapy, specific GLP-1 RAs and SGLT-2 inhibitors have a favorable effect on certain cardiovascular outcomes. PRIMARY FUNDING SOURCE: European Foundation for the Study of Diabetes, supported by an unrestricted educational grant from AstraZeneca. (PROSPERO: CRD42019122043). PMID: 32598218 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - June 29, 2020 Category: Internal Medicine Authors: Tsapas A, Avgerinos I, Karagiannis T, Malandris K, Manolopoulos A, Andreadis P, Liakos A, Matthews DR, Bekiari E Tags: Ann Intern Med 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

Cardiovascular Protection with Anti-hyperglycemic Agents
AbstractDiabetes mellitus is a major risk factor for cardiovascular (CV) disease. Conversely, CV disease is responsible for a majority of the deaths in patients with diabetes. Many drug trials have concentrated on blood glucose (hemoglobin A1c) reduction. This strategy, while reducing microvascular outcomes like nephropathy and neuropathy, has little or no effect on reducing macrovascular events like heart attack, stroke, and heart failure. It has been postulated that hypoglycemia may counterbalance some of the beneficial effects of anti-hyperglycemic agents, but this is not proven. Further, trial evidence for thiazolidine...
Source: American Journal of Cardiovascular Drugs - February 15, 2019 Category: Cardiology Source Type: research

The Evolving Role of the Cardiologist in the Management of Type 2 Diabetes
AbstractPurpose of ReviewTo evaluate the treatment of type 2 diabetes from a cardiologist ’s view.Recent FindingsA new era in the treatment of type 2 diabetes began for the cardiologist in 2015 with the publication of the EMPA-REG outcome trial finding a significant reduction in CV death with empagliflozin (oral sodium-glucose co-transporter-2 [SGLT2] inhibitor) in patients with type 2 diabetes at increased cardiovascular risk. Shortly thereafter, the injectable glucagon-like peptide agonists (GLP-1) liraglutide and semaglutide found a significant reduction in composite major cardiovascular events (CV death, non-fatal MI...
Source: Current Diabetes Reports - November 8, 2018 Category: Endocrinology Source Type: research

Treatment of Diabetes in Patients with Heart Failure
AbstractPurpose of ReviewThis review aims to summarize and discuss heart failure outcomes for current glucose-lowering agents in patients with type 2 diabetes mellitus.Recent FindingsCurrent regulations require cardiovascular outcomes trials for new glucose-lowering therapies to establish that there is no unacceptable increase in cardiovascular risk prior to approval. These cardiovascular outcomes trials include glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors. Overall, 87,162 patients have been studied in 10 published cardiovascular outcomes trials...
Source: Current Cardiology Reports - August 27, 2018 Category: Cardiology Source Type: research

New antihyperglycaemic agents and cardiovascular disease: let's be optimistic
Purpose of review Cardiovascular disease (CVD) substantially increases mortality in diabetes mellitus. This narrative review highlights recent research on the putative associations between dipeptyl peptidase 4 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium glucose co-transporter 2 inhibitors (SGLT-2is) and several cardiovascular risk factors. Recent findings New antihyperglycaemic agents favourably modulate several CVD risk factors, including fasting and postprandial plasma glucose levels, body weight, blood pressure, lipids, microalbuminuria, nonalcoholic fatty liver disease, serum uric a...
Source: Current Opinion in Cardiology - June 11, 2018 Category: Cardiology Tags: LIPIDS AND EMERGING RISK FACTORS: Edited by Dimitri P. Mikhailidis and Anthony S. Wierzbicki Source Type: research

The kidney and cardiovascular outcome trials
Chronic kidney disease (CKD) affects a substantial minority of people with type 2 diabetes (T2D). Analysis of US National Health and Nutrition Examination Survey (NHANES) datasets from 2007 through 2012 showed Stage 3 or worse disease (estimated glomerular filtration rate [eGFR] <60 mL/min per 1.73 m2) in nearly one in five patients, with increasing age, blood pressure, obesity, and levels of glycemia all associated with higher likelihood of Stage 3 or worse CKD, comparable to findings from surveys from many other areas, which also show micro‐ or macroalbuminuria to be present in one‐sixth to one‐third of diab...
Source: Journal of Diabetes - January 19, 2018 Category: Endocrinology Authors: Zachary Bloomgarden Tags: Editorial Source Type: research