Effects of antidiabetic drugs on the incidence of macrovascular complications and mortality in type 2 diabetes mellitus: a new perspective on sodium–glucose co-transporter 2 inhibitors

Rahelić, Dario; Javor, Eugen; Lucijanić, Tomo; Skelin, Marko

doi:10.1080/07853890.2016.1226514

Cited by 20 publications

(13 citation statements)

References 76 publications

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“…Macrovascular complications in diabetes primarily affect coronary arteries, peripheral arteries, and cerebrovasculature. Early macrovascular disease is associated with atherosclerotic plaque in the vasculature supplying blood to the heart, brain, limbs, and other organs while a late stage involves complete blockage of these vessels, which can increase the risks of myocardial infarction (MI), stroke, claudication, and gangrene [ 18 ]. Hence, the main target in the management of T2DM is maintaining good glycemic control, which is particularly important for controlling diabetes and preventing and delaying diabetes complications [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Micro-vessels are the basic functional unit of the CV system. They also regulate vascular permeability and myogenic responses, which can adapt blood flow according to local metabolic needs [ 18 ]. Diabetes induces pathognomonic changes in the microvasculature, affecting the capillary basement membrane, including arterioles in the glomeruli, retina, myocardium, skin, and muscle, by increasing their thickness, leading to the development of diabetic microangiopathy [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence

Sahay

Mittal

Gopal

et al. 2020

Cureus

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Objective To evaluate the usage of various strengths of glimepiride and metformin fixed-dose combinations in the management of type 2 diabetes mellitus (T2DM) patients with comorbidities and complications. Methods A retrospective, non-randomized, non-comparative, multi-centric real-world study included T2DM patients (age > 18 years) taking glimepiride and metformin fixed-dose combinations. Age, duration of diabetes, diabetes complications, comorbidities (hypertension and dyslipidemia), dosage frequency, and concomitant medications were analyzed from medical charts. Results A total of 4858 T2DM patients were included, with a mean age of 52.67 years and males being predominant in the study population (60.85%). The laboratory investigations showed a mean glycated hemoglobin (HbA1c) of 7.5, low-density lipoprotein (LDL) cholesterol of 104.81 ± 38.19 mg/dL, and serum creatinine of 0.88 ± 0.26 mg/dL. Around 2055 (42.30%) T2DM patients were hypertensive, and telmisartan alone and a telmisartan-based combination were the drugs of choice for hypertension management. Similarly, 1073 (22.08%) T2DM patients were having dyslipidemia and were primarily managed with rosuvastatin and its combination in 664 (62%) patients. Macrovascular complications were observed in 339 (6.97%) T2DM patients, among which coronary artery disease (CAD) had maximum prevalence, affecting 273 (5.61%) T2DM patients. Microvascular complications were 1010 (20.79%) T2DM patients, among which neuropathy had affected a maximum of 686 (14.12%) followed by retinopathy (2.34%) and nephropathy (1.81%). Among the available 11 strengths, the glimepiride 2 mg and metformin 500 mg combination were most widely prescribed in 1297 (26.69%), followed by glimepiride 1 mg and metformin 500 mg in 1193 (24.57%) patients, and the preferred dosage pattern was twice a daily in 2665 (54.85%) T2DM patients. An age-wise prescription analysis showed that glimepiride and metformin combinations were the preferred choice for the management of diabetes across all the age groups. Conclusion The real-world evidence in the Indian clinical setting indicates that glimepiride and metformin fixed-dose combinations are widely used in the management in T2DM patients with comorbidities like hypertension, dyslipidemia, and diabetes complications. Glimepiride and metformin fixed-dose combinations are suitable for early as well as long-standing diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence

Sahay

Mittal

Gopal

et al. 2020

Cureus

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“…Patients with T2DM are at a high risk of developing macrovascular events. Its treatment needs a multifactorial approach, as it results in the reduction of macrovascular complications and mortality related to type 2 diabetes (T2D) [2].…”

Section: Introductionmentioning

confidence: 99%

Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors: Benefits in Diabetics With Cardiovascular Disease

Aftab

Suresh

Sherali

et al. 2020

Cureus

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Optimal blood glucose control helps reduce the development of the complications of type II diabetes mellitus (T2DM). T2DM patients usually are at increased risk of cardiovascular (CV) events and mortality. Therapies and strategies to treat diabetes and its related CV outcomes still need more investigation to find the best management options for this population. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have several benefits over multiple organ systems of the human body. However, the comparative effectiveness of this drug class is still not well-established. Our review aims to assess SGLT-2 inhibitors' effects on the CV complications that occur because of uncontrolled diabetes. A comprehensive literature search was conducted on PubMed and PubMed Central to find the relevant studies that were done from 2016 through 2020 to gather data for this review article. Those studies include reviews, randomized clinical trials, systematic reviews, and meta-analyses. Studies used in this article found an associated decrease in CV complications and mortality in patients with T2DM who received treatment with SGLT-2 inhibitors compared to the placebo group. These drugs have shown significant efficacy and safety outcomes in diabetic patients with heart disease, as they are glycosuric and diuretics, both of which are characteristics that could provide benefits to this population. SGLT-2 inhibitors appear to reduce the risk of cardiovascular events and mortality, suggesting that the benefits of these drugs seen in people with diabetes may apply to a broad population in the real world. We recommend further studies should confirm the immense clinical benefits with SGLT-2 inhibitors in patients with T2DM.

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“…Type 2 diabetes mellitus (T2DM) is the most common form of DM, accounting for 91% of DM. Hyperglycemia control reduces the mortality and microvascular complications associated with the disease [ 2 , 3 ]. Diabetic retinopathy (DR) is one of the important microvascular complications of DM and is the leading cause of blindness in DM population.…”

Section: Introductionmentioning

confidence: 99%

Qualitative and Quantitative Analysis of B-Cell-Produced Antibodies in Vitreous Humor of Type 2 Diabetic Patients with Diabetic Retinopathy

Liu

et al. 2020

Journal of Diabetes Research

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Aim. To analyze the levels of B-cell-produced antibodies in the vitreous humor of patients with or without diabetic retinopathy (DR) both qualitatively and quantitatively. Methods. A total of 52 type 2 diabetes mellitus (T2DM) with DR patients and 52 control subjects without diabetes mellitus or inflammatory diseases were included in this prospective study. The levels of immunoglobulin (Ig)A, IgM, and IgG subtypes were measured using a magnetic color-bead-based multiplex assay. Results. The concentrations of IgA, IgM, and total antibodies in the DR group were significantly higher than those in the control group (all p<0.001), but there was no significant difference in the 4 IgG subtypes between the two groups after Bonferroni correction. Pearson’s correlation analysis revealed low negative correlations between levels of antibodies (IgA, IgM) and estimated glomerular filtration rate (eGFR, r=−0.443, r=−0.377, respectively, both p<0.05). Furthermore, multiple linear regression analysis yielded three equations to predict the concentrations of IgA, IgM, and total antibodies in the vitreous humor according to eGFR and other clinical variables (r=0.542, r=0.461, and r=0.312, respectively, all p<0.05). Conclusion. Increased levels of IgA, IgM, and total antibodies produced by B cells were observed in the vitreous humor of T2DM patients with DR. There were low negative correlations between levels of antibodies (IgA, IgM) and eGFR.

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Effects of antidiabetic drugs on the incidence of macrovascular complications and mortality in type 2 diabetes mellitus: a new perspective on sodium–glucose co-transporter 2 inhibitors

Cited by 20 publications

References 76 publications

Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence

Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence

Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors: Benefits in Diabetics With Cardiovascular Disease

Qualitative and Quantitative Analysis of B-Cell-Produced Antibodies in Vitreous Humor of Type 2 Diabetic Patients with Diabetic Retinopathy

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