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https://www.readbyqxmd.com/read/29764222/comparative-efficacy-of-once-weekly-semaglutide-and-sglt-2-inhibitors-in-type-2-diabetic-patients-inadequately-controlled-with-metformin-monotherapy-a-systematic-literature-review-and-network-meta-analysis
#1
Rohini Sharma, Lars Wilkinson, Hrvoje Vrazic, Evan Popoff, Sandra Lopes, Steve Kanters, Eric Druyts
OBJECTIVE: Treatment intensification with additional antidiabetic agents is recommended in type 2 diabetes (T2D) for patients inadequately controlled on metformin monotherapy. The present network meta-analysis (NMA) evaluated comparative efficacy and safety of once-weekly semaglutide and sodium-glucose co-transporter 2 inhibitors (SGLT-2is) in T2D patients inadequately controlled with metformin. METHODS: Randomized controlled trials with ≥20 weeks duration were searched in EMBASE, MEDLINE, and CENTRAL...
May 15, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29760945/liraglutide-and-dulaglutide-therapy-in-addition-to-sglt-2-inhibitor-and-metformin-treatment-in-indian-type-2-diabetics-a-real-world-retrospective-observational-study
#2
S Ghosal, B Sinha
Background: Therapy for Type 2 diabetes (T2D) has been transformed by the introduction of newer agents like Glucagon like Peptide Receptor Agonists (GLP-1RA) and Sodium-glucose linked transporter inhibitors (SGLT2i). However with co-initiation of SGLT2i and GLP-1RA in the DURATION 8 trial an improvement in HbA1c was noted but the beneficial effect was not equal to the sum of its parts. In view of this we proceeded to test the hypothesis that sequential addition of GLP-1RA therapy to metformin and SGLT-2i may be more beneficial...
2018: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29753563/critical-appraisal-of-the-2018-acc-scientific-sessions-late-breaking-trials-from-a-statistician-s-perspective
#3
REVIEW
Stuart J Pocock, Tim J Collier
The late-breaking clinical trials presentations at the American College of Cardiology Scientific Sessions in March 2018 are an important contribution to the field of cardiology. This paper presents a constructive critical appraisal of 7 key studies: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), VEST (Vest Prevention of Early Sudden Death Trial), SECURE-PCI (Statins Evaluation in Coronary Procedures and Revascularization), TREAT (Ticagrelor in Patients with ST-Elevation Myocardial Infarction treated with Pharmacological Thrombolysis), POISE (PeriOperative ISchemic Evaluation), SMART-DATE (Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome), and CVD-REAL 2 (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors)...
May 7, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29748368/cardiovascular-effects-of-new-oral-glucose-lowering-agents-dpp-4-and-sglt-2-inhibitors
#4
REVIEW
André J Scheen
Cardiovascular disease (CVD) is a major challenge in the management of type 2 diabetes mellitus. Glucose-lowering agents that reduce the risk of major cardiovascular events would be considered a major advance, as recently reported with liraglutide and semaglutide, 2 glucagon-like peptide-1 receptor agonists, and with empagliflozin and canagliflozin, 2 SGLT-2 (sodium-glucose cotransporter type 2) inhibitors, but not with DPP-4 (dipeptidyl peptidase-4) inhibitors. The present review is devoted to CV effects of new oral glucose-lowering agents...
May 11, 2018: Circulation Research
https://www.readbyqxmd.com/read/29732725/time-trends-and-geographical-variation-in-prescribing-of-drugs-for-diabetes-in-england-1998-2017
#5
Helen J Curtis, John M Dennis, Beverley M Shields, Alex J Walker, Seb Bacon, Andrew T Hattersley, Angus G Jones, Ben Goldacre
AIMS: UK guidelines for type II diabetes leave the choice of glucose lowering therapies after metformin largely to prescribers. They vary greatly in cost, and comparative effectiveness data is lacking. We set out to measure the variation in prescribing of these second-line non-insulin diabetes drugs. MATERIALS AND METHODS: We evaluated time trends 1998-2016, using England's publicly available prescribing datasets, and stratified by the order prescribed to patients using the Clinical Practice Research Datalink (CPRD)...
May 7, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29721589/cardiovascular-outcome-in-type-2-diabetes-and-atrial-fibrillation
#6
A Costard-Jäckle, D Tschöpe, T Meinertz
Diabetes is an independent risk factor for atrial fibrillation (AF). Frequently, it is part of the metabolic syndrome cluster, which includes obesity and hypertension that are independently associated with AF. The risk appears to be higher with longer duration of diabetes and inadequate glycemic control. Patients with diabetes and AF have a substantially increased risk of death and serious cardiovascular complications compared with those in sinus rhythm. Conversely, good metabolic control appears to be associated with maintenance of rhythm after successful therapeutic conversion to sinus rhythm by catheter ablation or electrical cardioconversion of AF...
May 2, 2018: Herz
https://www.readbyqxmd.com/read/29702499/new-antihyperglycaemic-agents-and-cardiovascular-disease-let-s-be-optimistic
#7
Kalliopi Pafili, Manfredi Rizzo, Nikolaos Papanas
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 acid, and arterial stiffness...
April 26, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29702252/direct-and-specific-inhibition-of-constitutive-nitric-oxide-synthase-uniquely-regulates-brush-border-membrane-na-absorptive-pathways-in-intestinal-epithelial-cells
#8
Balasubramanian Palaniappan, Uma Sundaram
Pharmacological manipulations of constitutive nitric oxide (cNO) levels have been shown to have variable effects on Na absorption in vivo and in vitro in different tissues. Species differences, untoward in vivo effects (e.g. ENS, blood flow) and pharmacological non-specificity may account for these confounding observations. Thus, to directly and specifically determine the effect of cNO on brush border membrane Na/H exchange (NHE3) and Na-dependent glucose co-transport (SGLT-1), we inhibited cNO synthase (cNOS) with its siRNA in rat small intestinal epithelial cells (IEC-18) in vitro...
April 24, 2018: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/29702076/prevention-of-progression-of-diabetic-nephropathy-by-the-sglt2-inhibitor-ipragliflozin-in-uninephrectomized-type-2-diabetic-mice
#9
Atsuo Tahara, Toshiyuki Takasu
Diabetic nephropathy is the leading cause of end-stage renal disease in the world. Although recent development of sodium-glucose cotransporter (SGLT) 2 inhibitors offers a new antidiabetic therapeutic strategy, it remains unclear whether such treatments are beneficial for limiting the progression of type 2 diabetic overt nephropathy. This study examined the effect of the SGLT2 inhibitor ipragliflozin on the progression of nephropathy in uninephrectomized KK/Ay type 2 diabetic mice, which exhibit not only typical diabetic symptoms such as hyperglycemia, hyperinsuemia, glucose intolerance, insulin resistance, hyperlipidemia, inflammation, and obesity, but also moderate hypertension and overt nephropathy with decline in renal function...
April 24, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29679303/do-the-sglt-2-inhibitors-offer-more-than-hypoglycemic-activity
#10
REVIEW
Eduardo Flores, Carlos G Santos-Gallego, Nely Diaz-Mejía, Juan Jose Badimon
Type 2 diabetes mellitus (T2DM) is one of the most common chronic health conditions in the USA; it affects approximately 10% of adults with up to one-quarter being undiagnosed. T2DM is associated with substantial cardiovascular (CV) morbidity and mortality. T2DM is a pathological condition characterized by elevated levels of glucose and associated with high CV risk. Traditional hypoglycemic drugs have demonstrated their capability for effective and maintained management of high glucose levels, but they have not significantly impacted on the incidence of CV events...
April 20, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29677303/association-between-use-of-sodium-glucose-cotransporter-2-inhibitors-glucagon-like-peptide-1-agonists-and-dipeptidyl-peptidase-4-inhibitors-with-all-cause-mortality-in-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#11
REVIEW
Sean L Zheng, Alistair J Roddick, Rochan Aghar-Jaffar, Matthew J Shun-Shin, Darrel Francis, Nick Oliver, Karim Meeran
Importance: The comparative clinical efficacy of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors for treatment of type 2 diabetes is unknown. Objective: To compare the efficacies of SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors on mortality and cardiovascular end points using network meta-analysis. Data Sources: MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, and published meta-analyses from inception through October 11, 2017...
April 17, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29663893/sglt-2-inhibition-novel-therapeutics-for-reno-and-cardioprotection-in-diabetes-mellitus
#12
Angus Gill, Stephen P Gray, Karin A Jandeleit-Dahm, Anna M D Watson
BACKGROUND: The sodium glucose co-transporter 2 (SGLT2) is primarily located within S1 of the renal proximal tubule being responsible for approximately 90% of glucose re-uptake in the kidney. Inhibition of SGLT2 is an exciting new pharmacological approach for the reduction of blood glucose in type 2 diabetic patients via inhibition of tubular glucose reabsorption. In addition to lowering glucose, this group of drugs has shown significant cardiovascular and renal protective effects. CONCLUSION: This review aims to outline the current state of preclinical research and clinical trials for different SGLT2 inhibitors and outline some of the proposed mechanisms of action, including possible effects on sympathetic nerve activity, which may contribute to the unexpected beneficial cardiovascular and reno-protective effects of this class of compounds...
April 17, 2018: Current Diabetes Reviews
https://www.readbyqxmd.com/read/29618313/sodium-glucose-cotransporter-2-inhibitors-the-impact-on-development-and-progression-of-heart-failure
#13
Vasilios Papademetriou, Eleni Geladari
BACKGROUND: Available hypoglycemic-agents enable physicians to achieve consistent glycemic-control, but effects on cardiovascular-outcomes have been marginal or questionable. SGLT-2 inhibitors emerged as a novel antidiabetic-drug class with remarkable cardiovascular benefits, and significant improvement in the prevention and progression of HF. OBJECTIVE: The purpose of this article is to critically review the effect of SGLT-2 inhibitors on HF-outcomes and the potential underlying mechanisms...
April 4, 2018: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/29602453/sglt2-inhibitor-induced-euglycaemic-diabetic-ketoacidosis-may-be-due-to-abrupt-severe-and-transient-impaired-glucose-sensing-in-susceptible-individuals-with-a-hitherto-unrecognised-beta-cell-sglt-variant
#14
F M Finucane
Euglycaemic diabetic ketoacidosis (EDKA) is a rare complication of treatment with SGLT2 inhibitors in patients with type 2 diabetes. Uncertainty remains about its precise mechanistic basis, but the physiological derangement is acute and profound, yet reversible with cessation of the drug. It is reminiscent of other "non type 1" presentations with DKA such as ketosis prone diabetes, except that glucose levels are usually normal. Impaired beta cell glucose sensing that mimicked a state of hypoglycaemia could theoretically lead to abrupt and transient cessation of insulin secretion...
May 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29589183/new-diabetes-therapies-and-diabetic-kidney-disease-progression-the-role-of-sglt-2-inhibitors
#15
REVIEW
Claire C J Dekkers, Ron T Gansevoort, Hiddo J L Heerspink
PURPOSE OF REVIEW: Sodium-glucose co-transporter 2 (SGLT-2) inhibitors have emerged as a promising drug class for the treatment of diabetic kidney disease. Developed originally as glucose-lowering drugs by enhancing urinary glucose excretion, these drugs also lower many other renal and cardiovascular risk factors such as body weight, blood pressure, albuminuria, and uric acid. Results from the EMPA-REG OUTCOME and CANVAS trials show that these salutary effects translate into a reduction in cardiovascular outcomes and have the potential to delay the progression of kidney function decline...
March 27, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29589153/an-exploratory-study-of-dapagliflozin-for-the-attenuation-of-albuminuria-in-patients-with-heart-failure-and-type-2-diabetes-mellitus-dapper
#16
Fumiki Yoshihara, Miki Imazu, Toshimitsu Hamasaki, Toshihisa Anzai, Satoshi Yasuda, Shin Ito, Haruko Yamamoto, Kazuhiko Hashimura, Yoshio Yasumura, Kiyoshi Mori, Masataka Watanabe, Masanori Asakura, Masafumi Kitakaze
BACKGROUND AND AIMS: Sodium-dependent glucose transporter-2 (SGLT-2) inhibitors, which are anti-diabetic drugs, reportedly decrease the incidence of cardiovascular events in high-risk patients with cardiovascular diseases, and thus chronic heart failure (CHF). SGLT-2 inhibitors also decrease albuminuria in patients with type 2 diabetes mellitus (T2D). Since albuminuria is a biomarker of not only chronic kidney disease but also cardiovascular events, we hypothesized that, among T2D patients with CHF, SGLT-2 inhibitors will decrease the extent of albuminuria and also improve CHF concomitantly...
March 28, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29573529/effects-of-the-sglt-2-inhibitor-dapagliflozin-on-glomerular-and-tubular-injury-markers
#17
Claire C J Dekkers, Sergei Petrykiv, Gozewijn D Laverman, David Z Cherney, Ron T Gansevoort, Hiddo J L Heerspink
The mechanisms by which SGLT-2 inhibitors lower albuminuria are incompletely understood. We assessed in a post-hoc analysis of a cross-over trial the effects of the SGLT2 inhibitor dapagliflozin on glomerular markers (IgG to IgG4 and IgG to albumin), tubular markers (urinary KIM-1, NGAL and LFABP) and inflammatory markers (urinary MCP-1 and IL-6) to provide more insight into kidney protective effects. Dapagliflozin decreased albuminuria by 43.9% (95% CI, 30.3%-54.8%) and eGFR by 5.1 (2.0-8.1) mL/min/1.73m2 compared to placebo...
March 24, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29569427/sodium-glucose-co-transporter-2-inhibitors-and-the-risk-for-diabetic-ketoacidosis-in-patients-with-type-2-diabetes-mellitus-a-nationwide-population-based-cohort-study
#18
Young-Gun Kim, Ja Young Jeon, Seung Jin Han, Dae Jung Kim, Kwan-Woo Lee, Hae Jin Kim
AIMS: The risk for diabetic ketoacidosis (DKA) associated with sodium-glucose co-transporter-2 inhibitor (SGLT-2i) treatment has not been established. Thus, we aimed to estimate the risk for DKA associated with SGLT-2i treatment compared to that with dipeptidyl-peptidase IV inhibitor (DPP-4i) treatment. METHODS: A nationwide population-based cohort study using claims data of the Korean Health Insurance Review and Assessment Service from January 1, 2013 to June 30, 2017 was performed...
March 22, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29569378/rates-of-myocardial-infarction-and-stroke-in-patients-initiated-on-sglt2-inhibitors-versus-other-glucose-lowering-agents-in-real-world-clinical-practice-results-from-the-cvd-real-study
#19
Mikhail Kosiborod, Kåre I Birkeland, Matthew A Cavender, Alex Z Fu, John P Wilding, Kamlesh Khunti, Reinhard W Holl, Anna Norhammar, Marit Eika Jørgensen, Eric T Wittbrodt, Marcus Thuresson, Johan Bodegård, Niklas Hammar, Peter Fenici
The multinational, observational CVD-REAL study recently showed that initiation of sodium-glucose co-transporter-2 inhibitors (SGLT-2i) was associated with significantly lower rates of death and heart failure vs. other glucose-lowering drugs (oGLDs). This sub-analysis of CVD-REAL sought to determine the association between initiation of SGLT-2i vs. oGLDs and rates of myocardial infarction (MI) and stroke. Medical records, claims and national registers from the US, Sweden, Norway and Denmark were used to identify patients with T2D newly initiated on SGLT-2i (canagliflozin, dapagliflozin or empagliflozin) or oGLDs...
March 22, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29554671/review-adding-a-dpp-4-inhibitor-to-an-sglt-2-inhibitor-reduces-genital-but-not-genitourinary-tract-infections
#20
René Rodriguez-Gutierrez, Victor M Montori
No abstract text is available yet for this article.
March 20, 2018: Annals of Internal Medicine
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