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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

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

Impact of glucose-lowering therapies on risk of stroke in type 2 diabetes.
Abstract Patients with type 2 diabetes (T2D) have an increased risk of stroke compared with people without diabetes. However, the effects of glucose-lowering drugs on risk of ischaemic stroke in T2D have been less extensively investigated than in coronary heart disease. Some evidence, including the UKPDS, has suggested a reduced risk of stroke with metformin, although the number of studies is limited. Inhibition of the KATP channels increases ischaemic brain lesions in animals. This is in agreement with a recent meta-analysis showing an increased risk of stroke with sulphonylureas vs. various comparators as both m...
Source: Diabetes and Metabolism - May 15, 2017 Category: Endocrinology Authors: Bonnet F, Scheen AJ Tags: Diabetes Metab Source Type: research