Tag Archives: SGLT2 inhibitors

Introduction Recent updates to guidelines for the management of type 2 diabetes (T2DM) have emphasised the importance of addressing cardiorenal risk and weight control, in conjunction with blood glucose regulation.1–4 All guidelines remain committed to lifestyle interventions (diet, physical activity and behavioural changes) as foundational therapy to be introduced at diagnosis, optimised and continued life-long. However, the progressive nature of T2DM typically requires the addition and dose-escalation of one or more blood glucose-lowering agents to achieve and maintain adequate glycaemic control.5 Several of the newer glucose-lowering ag

Heart failure – best of times The conference was opened by Professor Theresa McDonagh, who showcased both triumphs and ongoing challenges in heart failure. She began by highlighting the key ingredients needed for good heart failure management – starting with the invaluable contribution of heart failure nurses to patient care, bolstered by the British Heart Foundation (BHF), and ambitious targets for training specialist heart failure consultants, aiming for 25% representation in tertiary centres and a third in district general hospitals. The role of B-type naturietic peptide (BNP) in heart failure management was underscored as pivotal, al

Many randomised-controlled clinical trials (RCTs), such as DAPA-HF, DELIVER, EMPEROR-Preserved, EMPEROR-Reduced and CREDENCE trials have been conducted, using the different SGLT2 inhibitors, and have reported increased positive outcomes in the HF population.1–6 The mechanism(s) behind the cardiovascular protective effects by SGLT2 inhibitors remains unclear. Pleiotropic effects have been suggested; other plausible mechanisms include improved glycaemic control, reduced albuminuria, reduced blood pressure and amelioration of fluid overload.7 However, the increased use of this class of medications should be undertaken with awareness of the pot

New generation diabetes drugs – a cardiorenal done deal? The meeting was opened by Professor William Herrington (Honorary Consultant Nephrologist, Oxford Kidney Unit) who discussed the impact of the new generation diabetes drugs on kidney outcomes.1 A meta-analysis of over 90,000 patients showed that sodium glucose co-transporter-2 (SGLT2) inhibitors slowed chronic kidney disease (CKD) progression by 37%, and decreased the risk of acute kidney injury, cardiovascular (CV) death or heart failure hospitalisation by 23%, regardless, the presence of diabetes or type of SGLT2 inhibitor used. Implementing these drugs is simple and can be done by

25in25 The meeting began with an update on the 25in25 initiative from BSH Chair-Elect Dr Lisa Anderson (St George’s University Hospital, London). This national quality improvement initiative, led by the BSH in collaboration with over 54 national and international healthcare organisations, has the goal of reducing heart failure deaths by 25% over the next 25 years. With already over one million people in the UK living with heart failure, a number which is expected to double by 2040, the ambitious initiative is eagerly awaited. In the UK alone this could translate to over 10,000 lives saved per year. A population health approach underpins th

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Landmark trials in heart failure – 30 years from CONSENSUS With 2017 marking the 30th year since the publication of CONSENSUS,1 which first reported a reduction in mortality with enalapril versus placebo in patients with advanced heart failure (HF), the BCS held a dedicated session to review the seminal clinical trials and advances in chronic heart failure management in this period. Dr Rosita Zakeri (Royal Brompton Hospital, London) reviewed this session for us and spoke to the BJC afterwards. Rosita Zakeri The era of vasodilator therapy for heart failure began in the 1990s. Professor Karl Swedberg (University of Gothenberg, Sweden) began

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Introduction Type 2 diabetes mellitus is a major risk factor for developing both microvascular (retinopathy, nephropathy and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease and peripheral vascular disease).1 The link between maintaining good glycaemic control and prevention of these complications is well established.2-4 Guidelines recommend a target glycosylated haemoglobin (HbA1c) of 7% or less, but a large number of patients fail to meet this target and, as of yet, no ideal pharmacological blood glucose-lowering agent exists. Existing pharmacological therapies, which have been previously describ