Atherosclerosis – indicator for treatment of patient with type 2 diabetes mellitus
Authors:
Katarína Rašlová 1,2
Authors‘ workplace:
Metabolické centrum MUDr. Kataríny Rašlovej s. r. o., Bratislava
1; Koordinačné centrum pre familiárne hyperlipoproteinémie, SZU v Bratislave
2
Published in:
AtheroRev 2021; 6(2): 90-94
Category:
Reviews
Overview
Knowledge of physiological and pathophysiological processes in the regulation of glucose levels has brought new treatment options and new antidiabetics: glucagon-like peptide 1 receptor agonists (GLP1 RA) and sodium glucose cotransporter 2 (SGLT2i) inhibitors. Recently published prospective randomized studies have demonstrated their significant cardiovascular benefits without the risk of hypoglycemia and with a decrease or neutral effect on weight. The results of these studies were the reason for the publication of the new consensus of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). When choosing antidiabetic treatment, the ADA/EASD places special emphasis on reducing cardiovascular (CV) risk and body weight, low risk of hypoglycemia, but also on reducing the progression of renal complications. The position of metformin as a first-line medication does not change, as there is currently insufficient scientific evidence that metformin should not be the drug of the first choice. However, in patients at very high risk of CHD, combination therapy with SGLT2i or GLP1 RA with metformin should be initiated immediately.
Keywords:
Body weight – glucagon-like peptide 1 receptor agonists – hypoglycemia- macrovascular complications – sodium- glucose cotransporter 2 inhibitors – type 2 diabetes
Sources
1. DeFronzo RA. Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009; 58(4): 773–795. Dostupné z DOI: .
2. IDF Diabetes Atlas. 8th Edition 2017. Dostupné z WWW: .
3. Informace dostupné z WWW: .
4. Ray KK, Wilde MI, Sivakumaran R et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet 2009; 373(9677): 1765–1772. Dostupné z DOI: .
5. Lotufo PA, Gaziano JM, Chae CU et al. Diabetes and all-cause and coronary heart disease mortality among US male physicians. Arch Intern Med 2001; 161(2): 242–247. Dostupné z DOI: .
6. Juutilainen A, Lehto S, Rönnemaa T et al. Type 2 diabetes as a „coronary heart disease equivalent“: an 18-year prospective population-based study in Finnish subjects. Diabetes Care 2005; 28(12): 2901–2907. Dostupné z DOI: .
7. Schramm T K, Gislason GH, Køber L et al. Diabetes patients requiring glucose- lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people. Circulation 2008; 117(15): 1945–1954. Dostupné z DOI: .
8. Whiteley L, Padmanabhan S, Hole D et al. Should diabetes be considered a coronary heart disease risk equivalent?: results from 25 years of follow-up in the Renfrew and Paisley survey. Diabetes Care 2005; 28(7): 1588–1593. Dostupné z DOI: .
9. Davies MJ, D‘Alessio DA, Fradkin J et al. Management of Hyperglycaemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018; 41(12): 2669–2701. Dostupné z DOI: .
10. Buse JB, Wexler DJ, Tsapas A et al. 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2020; 43(2): 487–493. Dostupné z DOI: .
11. Zilov AV. Mechanisms of action of metformin with special reference to cardiovascular protection. Diabetes Metab Res Rev 2019; 35(7): e3173. Dostupné z DOI: .
12. Norton I, Shannon CE, Fourcaudot M et al. Sodium glucose transporter an d glucose transporter expression in the kidney. of type 2 diabetic subjects. Diabetes Obes Metab 2017; 19(9): 1322–1326. Dostupné z DOI: .
13. Liu Z, Ma X, Ilyas I et al. Impact of sodium glucose cotransporter 2 (SGLT2) inhibitors on atherosclerosis: from pharmacology to pre-clinical and clinical therapeutics. Theranostics 2021; 11(9): 4501–4515. Dostupné z DOI: .
14. Zinman B, Wanner C, Lachin JM et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: .
15. McGuire DK , Zinman B, Inzucchi SE et al. Effects of empagliflozin on first and recurrent clinical events in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a secondary analysis of the EMPA-REG OUTCOME trial. Lancet Diabetes Endocrinol 2020; 8(12): 949–959. Dostupné z DOI: .
16. Neal B, Perkovic V, Mahaffey KW et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med 2017; 377(7): 644–657. Dostupné z DOI: .
17. Wiviott SD, Raz I, Marc P. Bonaca MP et al. [DECLARE–TIMI 58 Investigators]. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019; 380(4): 347–357. Dostupné z DOI: .
18. Cannon CP, Pratley R, Dagogo-Jack S et al. for the VERTIS CV Investigators. Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes. N Engl J Med 2020; 383(15): 1425–1435. Dostupné z DOI: .
19. Zelniker TA, Wiviott SD, Raz I et al. et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet 2019; 393(10166): 31–39. Dostupné z DOI: .
20. Smith EP, An Z, D’Alessio DA et al. The role of β cell glucagon-like peptide- 1 signaling in glucose regulation and response to diabetes drugs. Cell Metab 2014; 19(6): 1050–1057. Dostupné z DOI: .
21. Drucker DJ. Mechanisms of Action and Therapeutic.Application of Glucagon- like Peptide-1. Cell Metabolism 27(4); 2018: 740–756. Dostupné z DOI: .
22. Knudsen LB and Lau J. The Discovery and Development of Liraglutide and Semaglutide. Front Endocrinol (Lausanne) 2019; 10: Article 155. Dostupné z DOI: .
23. Cornell S. A review of GLP-1 receptor agonists in type 2 diabetes: A focus on the mechanism of action of once-weekly agents J Clin Pharm Ther 2020; 45(Suppl 1): 17–27. Dostupné z DOI: .
24. Schubert M, Hansen S, Leefmann J et al. Repurposing Antidiabetic Drugs for Cardiovascular Disease. Front Endocrinol (Lausanne) 2020; 11: Article 568632. Dostupné z DOI: .
25. Kristensen SL, Rorth R, Jhund PS et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol 2019; 7(10): 776–785. Dostupné z DOI: .
26. Drucker DJ. The ascending GLP-1 road from clinical safety to reduction of cardiovascular complications. Diabetes 2018; 67(9): 1710–1719. Dostupné z DOI: .
27. Marso SP, Daniels GH, Brown-Frandsen K et al. Liraglutide and cardio- vascular outcomes in type 2 diabetes. N EnglJMed 2016; 375(4): 311–322. Dostupné z DOI: .
28. Marso SP, Bain SC, Consoli A et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375(19): 1834–1844. Dostupné z DOI: .
29. Hernandez AF, Green JB, Janmohamed S et al. [Harmony Outcomes committees and investigators]. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. Lancet 2018; 392(10157): 1519–1529. Dostupné z DOI: .
30. Gerstein HC, Colhoun HM, Dagenais GR et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo- controlled trial. Lancet 2019; 394(10193): 121–130. Dostupné z DOI: .
31. Holman RR, Bethel MA, Mentz RJ et al. [EXCEL Study group]. Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med; 2017; 377(13): 1228–1239. Dostupné z DOI: .
32. Marc A. Pfeffer, M.D., Ph.D., Brian Claggett, Ph.D., Rafael Diaz, M.D., et al. for the ELIXA Investigators. Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. N Engl J Med 2015; 373(23): 2247–2257. Dostupné z DOI: .
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Angiology Diabetology Internal medicine Cardiology General practitioner for adultsArticle was published in
Athero Review
2021 Issue 2
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