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Association of glucose-lowering drugs with incident stroke and transient ischaemic attacks in primary care patients with type 2 diabetes: disease analyzer database
ConclusionsTreatment with SGLT2 inhibitors or GLP-1 receptor agonists might reduce non-fatal stroke/TIA in persons with newly diagnosed type 2 diabetes.
Source: Acta Diabetologica - August 6, 2022 Category: Endocrinology 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

Could exercise be as effective as medication?
Conclusion The researchers found that there are very few trials that directly compare exercise with drug therapy for any condition. They were only able to find enough trials to be able to analyse results for four major conditions. They found that exercise reduced death rates for people after a stroke (although this analysis has limitations and should be interpreted cautiously), and that drug therapy with diuretics improved death rates for people with heart failure. They did not find any difference between exercise and drug therapy for death rates after a heart attack or in people with pre-diabetes. There were several limit...
Source: NHS News Feed - October 2, 2013 Category: Consumer Health News Tags: Lifestyle/exercise Heart/lungs Medication Source Type: news

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

People With Diabetes Are More Vulnerable to Heart Disease. How to Reduce the Risk
If you’ve been diagnosed with diabetes, know that you’ve got plenty of company. The American Diabetes Association (ADA) reports that in 2019, the most recent year for which data is available, 37.3 million adults in the U.S.—about 11.3% of the population—had the chronic condition, and that number continues to grow. Type 1 diabetes develops when the body isn’t able to produce insulin, and Type 2 occurs when the body doesn’t use insulin correctly. Type 2 is the most common form of diabetes, and when it’s uncontrolled, a person’s blood sugar can jump to dangerous levels that requ...
Source: TIME: Health - July 20, 2022 Category: Consumer Health News Authors: Elaine K. Howley Tags: Uncategorized Disease freelance healthscienceclimate Source Type: news

Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis
CONCLUSIONS: Findings from both standard and network meta-analyses of moderate- to high-certainty evidence suggest that GLP-1RA and SGLT2i are likely to reduce the risk of CVD mortality and all-cause mortality in people with established CVD; high-certainty evidence demonstrates that treatment with SGLT2i reduce the risk of hospitalisation for HF, while moderate-certainty evidence likely supports the use of GLP-1RA to reduce fatal and non-fatal stroke. Future studies conducted in the non-diabetic CVD population will reveal the mechanisms behind how these agents improve clinical outcomes irrespective of their glucose-lowerin...
Source: Cochrane Database of Systematic Reviews - October 25, 2021 Category: General Medicine Authors: Takayoshi Kanie Atsushi Mizuno Yoshimitsu Takaoka Takahiro Suzuki Daisuke Yoneoka Yuri Nishikawa Wilson Wai San Tam Jakub Morze Andrzej Rynkiewicz Yiqiao Xin Olivia Wu Rui Providencia Joey Sw Kwong Source Type: research

Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors Versus Metformin : A Cohort Study
CONCLUSION: As first-line T2D treatment, initiators receiving SGLT-2i showed a similar risk for MI/stroke/mortality, lower risk for HHF/mortality and HHF, and a similar safety profile except for an increased risk for genital infections compared with those receiving metformin.PRIMARY FUNDING SOURCE: Brigham and Women's Hospital and Harvard Medical School.PMID:35605236 | DOI:10.7326/M21-4012
Source: Annals of Internal Medicine - May 23, 2022 Category: Internal Medicine Authors: HoJin Shin Sebastian Schneeweiss Robert J Glynn Elisabetta Patorno Source Type: research

EMPA-REG and Other Cardiovascular Outcome Trials of Glucose-lowering Agents: Implications for Future Treatment Strategies in Type 2 Diabetes Mellitus.
Abstract During the last decade, the armamentarium for glucose-lowering drugs has increased enormously by the development of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors, allowing individualization of antidiabetic therapy for patients with type 2 diabetes (T2DM). Some combinations can now be used without an increased risk for severe hypoglycemia and weight gain. Following a request of the US Food and Drug Administration, many large cardiovascular (CV) outcome studies have been performed in patients with longstanding disease and established CV disease. In the majority of CV outcome studies, CV ris...
Source: Clinical Therapeutics - May 18, 2016 Category: Drugs & Pharmacology Authors: Schernthaner G, Schernthaner-Reiter MH, Schernthaner GH Tags: Clin Ther Source Type: research

Comparative cardiovascular risks of dipeptidyl peptidase ‐4 inhibitors with other 2nd and 3rd line antidiabetic drugs in patients with type 2 diabetes
ConclusionsDPP4i as 2nd and 3rd add‐on treatment provided cardiovascular benefits and posed no increased risks for heart failure, hypoglycemia and death.
Source: British Journal of Clinical Pharmacology - January 21, 2017 Category: Drugs & Pharmacology Authors: Huang ‐Tz Ou, Kai‐Cheng Chang, Chung‐Yi Li, Jin‐Shang Wu Tags: DRUG SAFETY Source Type: research

Comparative cardiovascular risks of dipeptidyl peptidase 4 inhibitors with other second ‐ and third‐line antidiabetic drugs in patients with type 2 diabetes
ConclusionsDPP4is as a second‐ or third‐line add‐on treatment provided cardiovascular benefits and posed no increased risks for heart failure, hypoglycaemia or death.
Source: British Journal of Clinical Pharmacology - February 26, 2017 Category: Drugs & Pharmacology Authors: Huang ‐Tz Ou, Kai‐Cheng Chang, Chung‐Yi Li, Jin‐Shang Wu Tags: DRUG SAFETY Source Type: research

Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus.
Conclusion: Compared with sulfonylureas, DPP-4 inhibitors were associated with lower risks for all-cause death, MACEs, ischemic stroke, and hypoglycemia when used as add-ons to metformin therapy. Primary Funding Source: None. PMID: 26457538 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 13, 2015 Category: Internal Medicine Authors: Ou SM, Shih CJ, Chao PW, Chu H, Kuo SC, Lee YJ, Wang SJ, Yang CY, Lin CC, Chen TJ, Tarng DC, Li SY, Chen YT Tags: Ann Intern Med Source Type: research

Assessment of the cardiovascular safety of saxagliptin in patients with type 2 diabetes mellitus: pooled analysis of 20 clinical trials
Conclusions: Analysis of pooled data from 20 clinical trials in patients with T2DM suggests that saxagliptin is not associated with an increased CV risk.
Source: Cardiovascular Diabetology - February 4, 2014 Category: Cardiology Authors: Nayyar IqbalArtist ParkerRobert FrederichMark DonovanBoaz Hirshberg Source Type: research

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