After completing this module, participants should be better able to understand:
- Cardiovascular (CV) randomised-controlled trials (RCTs) with newer hypoglycaemic agents have helped to guide therapies in diabetes. Agents in the dipeptidyl-peptidase family are CV neutral with some glucagon-like peptide (GLP) analogues showing vascular protection. Agents in the sodium-glucose co-transporter (SGLT) family have shown CV protection with the added benefit of reducing heart failure risk and potential favourable renal effects
- Data from one RCT should not be generalised to other members of the class, and each agent requires separate assessment
- The widespread belief that metformin is CV protective is, in our opinion, not based on robust evidence, although current knowledge suggests this agent is at worst CV neutral. In contrast, agents in the sulfonylurea group have been associated with increased CV risk, although conclusive large-scale CV outcome trials are currently lacking
- There is inconsistency in the quality of CV risk assessment comparing older and newer hypoglycaemic agents, which should be taken into account when drawing up guidelines and making treatment recommendations. Some recent guidelines have taken newer trial data into account when making recommendations for those with diabetes and CV disease
Sam M Pearson, Specialist Registrar in Diabetes and Endocrinology, St James’s University Hospital, Leeds
Ramzi A Ajjan, Associate Professor and Consultant in Diabetes and Endocrinology, The LIGHT Laboratories, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds
With thanks to Dr Sam Pearson for assistance on the self-assessment aspect of the programme.
0.5 CPD/CME credit, 0.5 hours
BJC Learning has assigned half an hour of CPD/CME credit to this module
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