المؤلفون: Pierre Gourdy, Patrice Darmon, François Dievart, Jean-Michel Halimi, Bruno Guerci

المصدر: Cardiovascular Diabetology, Vol 22, Iss 1, Pp 1-14 (2023)

مصطلحات موضوعية: Glucagon-like peptide-1 receptor agonists, Sodium-glucose cotransporter-2 inhibitors, Type 2 diabetes mellitus, Combination therapy, Cardiovascular protection, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Due to their cardiovascular protective effect, glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) represent breakthrough therapies for type 2 diabetes mellitus (T2DM). In this review article, we discuss the mechanistic and clinical synergies that make the combined use of GLP-1RAs and SGLT2is appealing in patients with T2DM. Overall, the presented cumulative evidence supports the benefits of GLP-1RA plus SGLT2i combination therapy on metabolic-cardiovascular-renal disease in patients with T2DM, with a low hypoglycemia risk. Accordingly, we encourage the adoption of GLP-1RA plus SGLT2i combination therapy in patients with T2DM and established atherosclerotic cardiovascular disease (ASCVD) or multiple risk factors for ASCVD (i.e., age ≥ 55 years, overweight/obesity, dyslipidemia, hypertension, current tobacco use, left ventricular hypertrophy, and/or proteinuria). Regarding renal effects, the evidence of SGLT2is in preventing kidney failure is more abundant than for GLP-1RAs, which showed a beneficial effect on albuminuria but not on hard kidney endpoints. Hence, in case of persistent albuminuria and/or uncontrolled metabolic risks (i.e., inadequate glycemic control, hypertension, overweight/obesity) on SGLT2i therapy, GLP-1RAs should be considered as the preferential add-on therapy in T2DM patients with chronic kidney disease. Despite the potential clinical benefits of GLP-1RA plus SGLT2i combination therapy in patients with T2DM, several factors may delay this combination to become a common practice soon, such as reimbursement and costs associated with polypharmacy. Altogether, when administering GLP-1RA plus SGLT2i combination therapy, it is important to adopt an individualized approach to therapy taking into account individual preferences, costs and coverage, toxicity profile, consideration of kidney function and glucose-lowering efficacy, desire for weight loss, and comorbidities.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1475-2840Test

الوصول الحر: https://doaj.org/article/6420101921534b9f9d011a67767b1819Test

المؤلفون: Dandan Xie, Yutong Li, Murong Xu, Xiaotong Zhao, Mingwei Chen

المصدر: Cardiovascular Diabetology, Vol 21, Iss 1, Pp 1-14 (2022)

مصطلحات موضوعية: Glucagon-like peptide-1 receptor agonists, Dulaglutide, Type 2 diabetes mellitus, Endothelial progenitor cells, Nitric oxide, Inflammatory factors, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Background Randomised controlled trial showed that dulaglutide can reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes mellitus (T2DM), but the underlying mechanisms remain unclear. This study aimed to investigate the effect of dulaglutide on the number and function of endothelial progenitor cells (EPCs) in the peripheral blood of patients with T2DM and its role in improving arterial elasticity, so as to determine potential mechanisms of preventive effect of dulaglutide on ASCVD. Methods Sixty patients with T2DM were treated with 1000 mg/day of metformin and randomly divided into two groups for 12 weeks: metformin monotherapy group (MET group, n = 30), and metformin combined with dulaglutide group (MET-DUL group, n = 30). Before and after treatment, the number of CD34+CD133+KDR+ EPCs and the brachial–ankle pulse wave velocity (baPWV) of the participants were measured, and EPC proliferation, adhesion, migration, and tubule formation were assessed in vitro. Results There were no significant differences in the number and function of EPCs and baPWV changes in MET group (P > 0.05). In MET-DUL group, nitric oxide (NO) levels and the number of EPCs increased after treatment (P

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1475-2840Test

الوصول الحر: https://doaj.org/article/cbe0dff8361847758a3ec2627da110bdTest

المؤلفون: Michael Razavi, Ying-Ying Wei, Xiao-Quan Rao, Ji-Xin Zhong

المصدر: Military Medical Research, Vol 9, Iss 1, Pp 1-15 (2022)

مصطلحات موضوعية: Glucagon-like peptide-1 receptor agonists, Dipeptidyl peptidase-4 inhibitors, Type 2 diabetes mellitus, Cardiovascular outcome, Medicine (General), R5-920, Military Science

الوصف: Abstract Glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors are commonly used treatments for patients with type 2 diabetes mellitus (T2DM). Both anti-diabetic treatments function by playing key modulatory roles in the incretin system. Though these drugs have been deemed effective in treating T2DM, the Food and Drug Administration (FDA) and some members of the scientific community have questioned the safety of these therapeutics relative to important cardiovascular endpoints. As a result, since 2008, the FDA has required all new drugs for glycemic control in T2DM patients to demonstrate cardiovascular safety. The present review article strives to assess the safety and benefits of incretin-based therapy, a new class of antidiabetic drug, on the health of patient cardiovascular systems. In the process, this review will also provide a physiological overview of the incretin system and how key components function in T2DM.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2054-9369Test

الوصول الحر: https://doaj.org/article/d8f3f4f51e8f47c884d0ced18e16a237Test

المؤلفون: Yi-Hsin Chan, Tze-Fan Chao, Shao-Wei Chen, Hsin-Fu Lee, Pei-Ru Li, Wei-Min Chen, Yung-Hsin Yeh, Chi-Tai Kuo, Lai-Chu See, Gregory Y. H. Lip

المصدر: Cardiovascular Diabetology, Vol 21, Iss 1, Pp 1-13 (2022)

مصطلحات موضوعية: Atrial fibrillation, Type 2 diabetes mellitus, Sodium-glucose cotransporter-2 inhibitor, Glucagon-like peptide-1 receptor agonist, Dipeptidyl peptidase-4 inhibitor, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Background Although a few meta-analyses were conducted to compare the risk of incident atrial fibrillation (AF) between sodium-glucose cotransporter-2 inhibitor (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and other anti-hyperglycemic agents using indirect or direct comparison, the above analyses showed conflicting results with each other. We aimed to evaluate the risk of new-onset AF associated with the use of SGLT2i, GLP-1RA, and dipeptidyl peptidase-4 inhibitor (DPP4i) among a large longitudinal cohort of diabetic patients. Methods In this nationwide retrospective cohort study based on the Taiwan National Health Insurance Research Database, a total of 344,893, 44,370, and 393,100 consecutive patients with type 2 diabetes without preexisting AF receiving GLP-1RA, SGLT2i, and DPP4i, respectively, were enrolled from May 1, 2016, to December 31, 2019. We used 1:1 propensity score matching (PSM) to balance covariates across paired study groups. Patients were followed from the drug index date until the occurrence of AF, death, discontinuation of the index drug, or the end of the study period (December 31, 2020), whichever occurred first. Results After PSM, there were 245,442, 43,682, and 39,190 paired cohorts of SGLT2i-DPP4i, SGLT2i-GLP-1RA, and GLP-1RA-DPP4i, respectively. SGLT2i treatment was associated with lower risk of new-onset AF in participants with type 2 diabetes compared with either DPP4i [hazard ratio (HR):0.90; 95% confidential interval (CI) 0.84–0.96; P = 0.0028] or GLP-1RA [HR 0.74; 95% CI 0.63–0.88; P = 0.0007] treatment after PSM. There was no difference in the risk of incident AF between GLP-1RA and DPP4i users [HR 1.01; 95% CI 0.86–1.19; P = 0.8980]. The above findings persisted among several important subgroups. Dapagliflozin was specifically associated with a lower risk of new-onset AF compared with DPP4i (P interaction = 0.02). Conclusions Compared with DPP4i, SGLT2i but not GLP-1RA was associated with a lower risk of incident AF in patients with type 2 diabetes.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1475-2840Test

الوصول الحر: https://doaj.org/article/30c52b77a955482386a127decc23bebaTest

المؤلفون: Daisuke Ugamura, Michihiro Hosojima, Hideyuki Kabasawa, Naohito Tanabe, Yuta Yoshizawa, Yoshiki Suzuki, Akihiko Saito, Ichiei Narita

المصدر: Renal Replacement Therapy, Vol 8, Iss 1, Pp 1-10 (2022)

مصطلحات موضوعية: Dulaglutide, Glucagon-like peptide-1 receptor agonist, Hemodialysis, Once-weekly, Type 2 diabetes mellitus, Diseases of the genitourinary system. Urology, RC870-923

الوصف: Abstract Background Dulaglutide is a once-weekly glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of type 2 diabetes mellitus (T2DM). However, the efficacy and safety of dulaglutide remain unclear in insulin-treated patients with T2DM on maintenance hemodialysis (HD). Methods Dulaglutide treatment was initiated, and the insulin dose was adjusted according to the needs of individual participants. Primary outcomes were changes in the mean and standard deviation (SD) of blood glucose (BG) levels and mean amplitude of glycemic excursions (MAGE) evaluated by continuous glucose monitoring (CGM) for six days, glycated albumin (GA), glycated hemoglobin (HbA1c), pre-dialysis blood glucose levels, and daily total insulin dose from the baseline over 24 weeks. Secondary outcomes were changes in treatment satisfaction and QOL levels from the baseline, measured by using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Diabetes Therapy-Related Quality of Life questionnaire (DTR-QOL) scores. Results The analysis was performed on the 12 participants who completed the study. The GA level (median − 1.8 [interquartile range − 6.6, − 0.3] %; p = 0.026) and daily total insulin dose (− 15.0 [− 24.5, − 9.4] U/day; p = 0.002) significantly decreased without increasing hypoglycemia (area over the glucose curve

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2059-1381Test

الوصول الحر: https://doaj.org/article/9484b1ee88574ef999248bec088e4435Test

المؤلفون: Bernard M.Y. Cheung, Man Fung Tsoi, Yue Fei

المصدر: Cardiovascular Diabetology, Vol 18, Iss 1, Pp 1-13 (2019)
Cardiovascular Diabetology

مصطلحات موضوعية: medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Placebo, Antidiabetic drug, Incretins, Risk Assessment, Glucagon-Like Peptide-1 Receptor, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Cause of Death, Internal medicine, Diabetes mellitus, Type 2 diabetes mellitus, medicine, Humans, Myocardial infarction, Network meta-analysis, Sodium-Glucose Transporter 2 Inhibitors, Original Investigation, Angiology, Clinical Trials as Topic, Dipeptidyl-Peptidase IV Inhibitors, business.industry, Type 2 Diabetes Mellitus, Cardiovascular outcome, medicine.disease, Hospitalization, Treatment Outcome, Diabetes Mellitus, Type 2, Cardiovascular Diseases, lcsh:RC666-701, Heart failure, Meta-analysis, Cardiology and Cardiovascular Medicine, business, Mace

الوصف: Background Recent trials suggested that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose co-transporter-2 (SGLT-2) inhibitors reduced cardiovascular events. Comparative effectiveness of these new antidiabetic drug classes remains unclear. We therefore performed a network meta-analysis to compare the effect on cardiovascular outcomes among GLP-1 RAs, SGLT-2 and dipeptidyl peptidase-4 (DPP-4) inhibitors. Methods MEDLINE, EMBASE, Cochrane database, ClinicalTrials.gov, and congress proceedings from recent cardiology conferences were searched up to April 20, 2019. Cardiovascular outcome trials and renal outcome trials reporting cardiovascular outcomes on GLP-1 RAs, SGLT-2 and DPP-4 inhibitors in patients with type 2 diabetes mellitus were included. The primary outcome was major adverse cardiovascular events (MACE). Secondary outcomes were nonfatal myocardial infarction, nonfatal stroke, cardiovascular mortality, all-cause mortality, hospitalisation for heart failure (HF), and renal composite outcome. ORs and 95% CI were calculated using random-effects models. Results Fourteen trials enrolling 121,047 patients were included. SGLT-2 inhibitors reduced cardiovascular deaths and all-cause deaths compared to placebo (OR 0.82, 95% CI 0.73–0.93 and OR 0.84, 95% CI 0.77–0.92) and DPP-4 inhibitors (OR 0.83, 95% CI 0.70–0.99 and OR 0.83, 95% CI 0.73–0.94), respectively. SGLT-2 inhibitors and GLP-1 RAs significantly reduced MACE (OR 0.88, 95% CI 0.82–0.95 and OR 0.87, 95% CI 0.82–0.93), hospitalisation for HF (OR 0.68, 95% CI 0.61–0.77 and OR 0.87, 95% CI 0.82–0.93), and renal composite outcome (OR 0.59, 95% CI 0.52–0.67 and OR 0.86, 95% CI 0.78–0.94) compared to placebo, but SGLT-2 inhibitors reduced hospitalisation for HF (OR 0.79, 95% CI 0.69–0.90) and renal composite outcome (OR 0.69, 95% CI 0.59–0.80) more than GLP-1 RAs. Only GLP-1 RAs reduced nonfatal stroke (OR 0.88, 95% CI 0.77–0.99). DPP-4 inhibitors did not lower the risk of these outcomes when compared to placebo and were associated with higher risks of MACE, hospitalisation for HF, and renal composite outcome when compared to the other two drug classes. Conclusions SGLT-2 inhibitors show clear superiority in reducing cardiovascular and all-cause deaths, hospitalisation for HF, and renal events among new antidiabetic drug classes. GLP-1 RAs also have cardiovascular and renal protective effects. DPP-4 inhibitors have no beneficial cardiovascular effects and are therefore inferior to the other two drug classes. SGLT-2 inhibitors should now be the preferred treatment for type 2 diabetes mellitus.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::47341feb96e16e17488e345929f99d8dTest
http://link.springer.com/article/10.1186/s12933-019-0916-zTest

المؤلفون: Ciro Mauro, Giuseppe Paolisso, Claudio de Lucia, Michelangela Barbieri, Raffaele Marfella, Celestino Sardu, Maria Rosaria Rizzo, Antonio Ruocco, Matteo Santamaria, Cosimo Sacra, Pasquale Paolisso

المساهمون: Sardu, Celestino, Paolisso, Pasquale, Sacra, Cosimo, Santamaria, Matteo, de Lucia, Claudio, Ruocco, Antonio, Mauro, Ciro, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Barbieri, Michelangela, Marfella, Raffaele

المصدر: Cardiovascular Diabetology, Vol 17, Iss 1, Pp 1-16 (2018)
Cardiovascular Diabetology

مصطلحات موضوعية: Blood Glucose, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030204 cardiovascular system & hematology, Systemic inflammation, Ventricular Function, Left, Cardiac Resynchronization Therapy, 0302 clinical medicine, Risk Factors, Prospective Studies, Prospective cohort study, Original Investigation, Ejection fraction, Middle Aged, Defibrillators, Implantable, Treatment Outcome, Italy, Disease Progression, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Cardiac resynchronization therapy, Electric Countershock, 030209 endocrinology & metabolism, Incretins, Patient Readmission, Glucagon-Like Peptide-1 Receptor, 03 medical and health sciences, Internal medicine, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Cardiac Resynchronization Therapy Devices, Angiology, Aged, Heart Failure, business.industry, Type 2 Diabetes Mellitus, Arrhythmias, Cardiac, Recovery of Function, medicine.disease, Diabetes Mellitus, Type 2, lcsh:RC666-701, Heart failure, business, Biomarkers

الوصف: Objectives To evaluate clinical outcomes in patients with diabetes, treated by cardiac resynchronization therapy with a defibrillator (CRT-d), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) in addition to conventional hypoglycemic therapy vs. CRTd patients under conventional hypoglycemic drugs. Background Patients with diabetes treated by CRTd experienced an amelioration of functional New York Association Heart class, reduction of hospital admissions, and mortality, in a percentage about 60%. However, about 40% of CRTd patients with diabetes experience a worse prognosis. Materials and methods We investigated the 12-months prognosis of CRTd patients with diabetes, previously treated with hypoglycemic drugs therapy (n 271) vs. a matched cohort of CRTd patients with diabetes treated with GLP-1 RA in addition to conventional hypoglycemic therapy (n 288). Results At follow up CRTd patients with diabetes treated by GLP-1 RA therapy vs. CRTd patients with diabetes that did not receive GLP-1 RA therapy, experienced a significant reduction of NYHA class (p value Conclusions GLP-1 RA drugs in addition to conventional hypoglycemic therapy may significantly reduce systemic inflammation and circulating BNP levels in CRTd patients with diabetes, leading to a significant improvement of LVEF and of the 6 min walking test, and to a reduction of the arrhythmic burden. Consequently, GLP-1 RA drugs in addition to conventional hypoglycemic therapy may reduce hospital admissions for heart failure worsening, by increasing CRTd responders rate. Trial registration NCT03282136. Registered 9 December 2017 “retrospectively registered”

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b637835afe49190913e16a04ccabae61Test
http://link.springer.com/article/10.1186/s12933-018-0778-9Test