Cardiovascular Outcomes Trials in Type 2 Diabetes Mellitus

Abstract

Objectives: To review the spectrum of contemporary cardiovascular outcomes trials (CVOTS) in type 2 diabetes mellitus (T2DM), spanning both the pre- and post-ACCORD eras. Methods: We reviewed a total of 12 CVOTs and delineated the two eras in accordance with the 2008 US Food and Drug Administration (FDA) mandate requiring completion of CVOTs prior the licensing of new glucose-lowering agents. The salient implications regarding macrovascular disease complications were summarized. Results: Five trials in the pre-ACCORD and 7 in the post-ACCORD era were identified. Heterogeneous results pertaining to the degree of glycemic control associated with optimal macrovascular disease risk reduction, as well as the safest pharmacologic means to do so, were observed. Conclusions: The post-ACCORD era is representative of a significant shift in the landscape of CVOTs in T2DM, with an emphasis on safety of glucose-lowering agents. Recently completed and ongoing trials of dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter 2 inhibitors will continue to inform clinical practice on safe and effective ways to reduce CV risk in T2DM.

Cardiovascular Comorbidities Are the Main Predictors of Cardiac Reverse Remodeling following Kidney Transplantation

“…DM contributes to different types of LV remodeling such as LV hypertrophy, diastolic dysfunction and impaired systolic function, which is associated with a higher incidence of most CV outcomes 13,14 . Specifically, diastolic dysfunction may derive from the myocardial deposition of collagen and advanced glycation end products as well as relative myocardial hypertrophy 15 .…”

The History of Insulin Technology: A Brief Review of the Updates in Basal Insulin Therapy Through the Years

“…Outcomes Trials Since 2008, cardiovascular (CV) outcomes trials have been required for all new antihyperglycemic agents (100). At the time of this publication submission, CV outcomes have been reported for two GLP-1 RAs: liraglutide (15% reduction in all-cause mortality [P = .02];…”