Tag Archives: type 2 diabetes

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

The EU approval is based on positive results from the landmark DAPA-HF phase III trial, published in The New England Journal of Medicine (DOI: 10.1056/NEJMoa1911303) and follows the recommendation for approval by the Committee for Medicinal Products for Human Use of the European Medicines Agency. Dapagliflozin is the first SGLT2 inhibitor to have shown a statistically significant reduction in the risk of the composite of cardiovascular death or worsening of heart failure events, including hospitalisation for HF.

The American Diabetes Association Scientific Sessions 2019 were held in San Francisco REWIND One of the highlights of the conference and, for many, the main event was the presentation of results from REWIND (Researching CV Events with a Weekly Incretin in Diabetes), a cardiovascular outcome trial (CVOT) for the GLP-1 receptor agonist (GLP-1RA) dulaglutide.1 Prior to this trial, the majority of CVOTs (and all prior CVOTs with GLP-1 RAs) were conducted in a predominantly secondary prevention population. Thus any positive cardiovascular (CV) outcomes were only shown in those with established atherosclerotic cardiovascular disease (ASCVD). The ba

Stat tests loaded into the VITROS XT 7600 Moderate alcohol consumption does not protect against stroke Blood pressure and stroke risk increase steadily with increasing alcohol intake, and previous claims that one to two alcoholic drinks a day might protect against stroke are not borne out by new evidence from a genetic study involving 160,000 adults. Studies of East Asian genes, where two common genetic variants strongly affect what people choose to drink, show that alcohol itself directly increases blood pressure and the chances of having a stroke, according to a new study published in The Lancet (doi: 10.1016/S0140-6736(18)31772-0). Researc

Non-inferior cardiovascular outcome for DPP-4 inhibitor Results from the CAROLINA cardiovascular outcome study show that the DPP-4 inhibitor linagliptin (Trajenta®, Boehringer Ingelheim and Eli Lilly) is non-inferior to the sulphonylurea glimepiride in the treatment of adults with type 2 diabetes and cardiovascular risk. The study met its primary end point – defined as the non-inferiority of linagliptin versus glimepiride in time to first occurrence of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke. The study, carried out over six years in 6,033 adults with type 2 diabetes and increased cardiovascular risk or est

Dr Sean L Zheng CVOTs The key studies evaluated sodium-glucose co-transporter 2 (SGLT2) inhibitors – empagliflozin (EMPA-REG OUTCOME)4 and canagliflozin (CANVAS)5 – and glucagon-like peptide 1 (GLP-1) receptor agonists – liraglutide (LEADER)6 and semaglutide (SUSTAIN-6)7 – in patients with type 2 diabetes and cardiovascular disease or elevated cardiovascular risk (table 1). In the EMPA-REG OUTCOME (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients–Removing Excess Glucose) study, the use of empagliflozin resulted in 38% and 35% reductions in cardiovascular death and heart failure hospitalisation, r

Self-monitoring of type 2 diabetes cuts costs Self-monitoring of type 2 diabetes used in combination with an electronic feedback system results in considerable savings on health care costs and also travel costs for patients, especially in sparsely populated areas, a new study shows. The study, carried out in Northern Karelia by the University of Eastern Finland, found that by replacing half of the required follow-up visits for type 2 diabetes with self-measurements and electronic feedback, total costs of glycated haemoglobin monitoring were reduced by nearly 60%. The annual per-patient cost was down from 280 euros to 120 euros. Fewer follow-u

The changing cardiovascular risk imposed by type 2 diabetes Once upon a time, type 2 diabetes was considered a coronary heart disease (CHD) risk equivalent, meaning that the risk of a future CHD event was considered equal to patients with existing vascular disease. While this notion has been superseded, the risk for a range of vascular outcomes (myocardial infarction [MI], stroke or deaths due to other vascular diseases) appears approximately double in diabetes compared with the general population (figure 1).1 Less well appreciated is the observation that diabetes increases the risk of fatal events somewhat more than non-fatal, for reasons n

Introduction Type 2 diabetes (T2D) is a global epidemic with changing demographics that poses a huge challenge for the health and economy of all nations and ethnicities. Ethnicity is defined in terms of a culture of people in a given geographic region, including their language, heritage, religion and customs.1 South Asians constitute about 1.6 billion people from the countries of the Indian subcontinent, this includes Afghanistan, Bangladesh, Bhutan, India, Maldives, Pakistan, Nepal and Sri Lanka.2 Over 37 million ethnic South Asian diaspora live across every continent.3 Prevalence of diabetes in South Asians According to the International D

Introduction Individuals with diabetes are at increased risk of vascular outcomes, and their prognosis following an event remains worse compared with those having normal glucose metabolism.1 The relationship between glycaemia and vascular disease is complex as it is affected by multiple glucose parameters, including chronic hyperglycaemia, hypoglycaemia and, potentially, glycaemic variability.2 To add to the complexity, the type of hypoglycaemic agent used may also alter predisposition to vascular events. Over a decade ago, one hypoglycaemic agent, rosiglitazone, was implicated in increasing the risk of vascular disease, which prompted the U