Comparative cardiovascular safety of insulin secretagogues following hospitalization for ischemic heart disease among type 2 diabetes patients: a cohort study

Huang, Yuhao; Abdel‐Moneim, Ahmed S.; Light, Peter E.; Qiu, Weiliang; Simpson, Scot H.

doi:10.1016/j.jdiacomp.2014.11.012

Cited by 17 publications

(10 citation statements)

References 43 publications

(58 reference statements)

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“…A retrospective, Canadian, cohort study of type 2 diabetic patients hospitalized for ischemic heart disease showed a 30-day incidence of NAF with use of glyburide (9.7%), glicizide (10.7%) and repaglinide (9.8%). 66 which was confirmed with multivariate analysis that did not correct for the use of sulfonylureas. However, because of the widespread use of sulfonylureas and meglitinide in the comparison group, these results could be interpreted as representing an increase in NAF with use of secretagogues.…”

Section: Drugs With the Potential To Stimulate The Sympathetic Nervmentioning

confidence: 84%

“…There are no prospective studies of monotherapy with sulfonylureas that can reliably assess their effect on NAF. A retrospective, Canadian, cohort study of type 2 diabetic patients hospitalized for ischemic heart disease showed a 30‐day incidence of NAF with use of glyburide (9.7%), glicizide (10.7%) and repaglinide (9.8%) . There are, however, studies that compare sulfonylureas with DPP‐4 inhibitors which indirectly suggest that use of sulfonylureas may increase the incidence of NAF.…”

Section: Drugs With the Potential To Stimulate The Sympathetic Nervoumentioning

confidence: 98%

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Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Bell

Goncalves

2018

Diabetes Obesity Metabolism

110

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New-onset atrial fibrillation (NAF) is increased in the type 2 diabetic patient because of the presence of the metaboli syndrome and increased sympathetic activity. This results in inflammation, endothelial dysfunction and myocardial steatosis which, in turn, lead to atrial fibrosis and dilatation. The end result is the development of structural and electrical atrial remodeling. Drugs that lower insulin resistance, particularly pioglitazone, decrease the incidence of NAF while drugs that, through hypoglycaemia, stimulate the sympathetic nervous system, insulin and secretagogues, increase the incidence of NAF. Currently there is no evidence that GLP-1 agonists, SGLT2 inhibitors and DPP-4 inhibitors either accelerate or decelerate the development of NAF.

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Section: Drugs With the Potential To Stimulate The Sympathetic Nervmentioning

confidence: 84%

Section: Drugs With the Potential To Stimulate The Sympathetic Nervoumentioning

confidence: 98%

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Bell

Goncalves

2018

Diabetes Obesity Metabolism

110

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“…In the large NAVIGATOR RCT 94 , nateglinide did not alter cardiovascular outcomes in people with impaired glucose tolerance who either had, or were at high risk of, cardiovascular disease. No association has been demonstrated between repaglinide and either cardiovascular disease or cardiovascular risk 65,83,95 .…”

Section: Figure 3 | Sulfonylureas Meglitinides and Glucagon-like Pepmentioning

confidence: 99%

Pharmacology and therapeutic implications of current drugs for type 2 diabetes mellitus

2016

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Type 2 diabetes mellitus (T2DM) is a global epidemic that poses a major challenge to health-care systems. Improving metabolic control to approach normal glycaemia (where practical) greatly benefits long-term prognoses and justifies early, effective, sustained and safety-conscious intervention. Improvements in the understanding of the complex pathogenesis of T2DM have underpinned the development of glucose-lowering therapies with complementary mechanisms of action, which have expanded treatment options and facilitated individualized management strategies. Over the past decade, several new classes of glucose-lowering agents have been licensed, including glucagon-like peptide 1 receptor (GLP-1R) agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors and sodium/glucose cotransporter 2 (SGLT2) inhibitors. These agents can be used individually or in combination with well-established treatments such as biguanides, sulfonylureas and thiazolidinediones. Although novel agents have potential advantages including low risk of hypoglycaemia and help with weight control, long-term safety has yet to be established. In this Review, we assess the pharmacokinetics, pharmacodynamics and safety profiles, including cardiovascular safety, of currently available therapies for management of hyperglycaemia in patients with T2DM within the context of disease pathogenesis and natural history. In addition, we briefly describe treatment algorithms for patients with T2DM and lessons from present therapies to inform the development of future therapies.

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“…Meglitinides have been related to variable degrees of undesirable CVD risks [ 30 ]. Repaglinide, a meglitinide that acts by closing ATP-dependent potassium channels, appears to be associated with a risk of adverse cardiovascular sequelae similar to that for SU [ 30 ].…”

Section: Comparative Cvd Risks Of Dpp4i With Other Antidiabetic Drugsmentioning

confidence: 99%

Risks of cardiovascular diseases associated with dipeptidyl peptidase-4 inhibitors and other antidiabetic drugs in patients with type 2 diabetes: a nation-wide longitudinal study

Chang

et al. 2016

Cardiovasc Diabetol

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BackgroundSeveral antidiabetic drugs (i.e., sulfonylureas; SU, rosiglitazone) have been reported to be associated with increased risks of cardiovascular diseases (CVD) in patients with type 2 diabetes mellitus (T2DM). Dipeptidyl peptidase-4 inhibitors (DPP4i) are newly available antidiabetic drugs. Most studies only compared DPP4i with a placebo or SU, or targeted a specific CVD event of interest (i.e., heart failure; HF). Comparative research of CVD risks of DPP4i with other antidiabetic drugs (i.e., metformin, thiazolidinediones, meglitinides, acarbose, and insulin) remains scarce. This study was aimed to assess comparative risks of CVD, including ischemic stroke, myocardial infarction (MI) and HF, and hypoglycemia of DPP4i with other antidiabetic drugs.MethodsWe utilized Taiwan’s National Health Insurance Research Database. A total of 123,050 T2DM patients newly prescribed oral antidiabetic treatments were identified in 2009–2010 and followed until 2013. Outcome endpoints included a composite of CVD events: hospitalizations for ischemic stroke, MI and HF, and hypoglycemia. Time-varying Cox proportional hazards regression was applied to assess the time to event hazards of various antidiabetic drugs, adjusted for patients’ demographics, comorbidity, diabetic complications, and co-medications. Additional analyses were performed for the patients with and without CVD history, respectively.ResultsDPP4i users had significantly lower CVD risks as compared to that of non-DPP4i users (adjusted hazard ratio [aHR]: 0.83, 95 % confidence interval [CI]: 0.76–0.91). Compared to DPP4i users, meglitinides (aHR 1.3, 95 % CI 1.20–1.43) and insulin users (aHR 3.73, 95 % CI 3.35, 4.14) had significantly higher risks for composite CVD, as well as those for stroke, MI, HF, and hypoglycemia. Additionally, metformin users had significantly lower risks for composite CVD risk (aHR 0.87, 95 % CI 0.79–0.94), as well as those for MI, HF, and hypoglycemia, as compared to those of DPP4i users. Although there was a trend toward low CVD risks in pioglitazone users, the role of potential confounding by indication cannot be excluded.ConclusionsDPP4i-treated T2DM patients had lower risks for CVD as compared to those for non-DPP4i users, except metformin users.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0350-4) contains supplementary material, which is available to authorized users.

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Comparative cardiovascular safety of insulin secretagogues following hospitalization for ischemic heart disease among type 2 diabetes patients: a cohort study

Cited by 17 publications

References 43 publications

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Pharmacology and therapeutic implications of current drugs for type 2 diabetes mellitus

Risks of cardiovascular diseases associated with dipeptidyl peptidase-4 inhibitors and other antidiabetic drugs in patients with type 2 diabetes: a nation-wide longitudinal study

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