Glycemic Control and Cardiovascular Risk Factor Management in Adults With Type 2 Diabetes With and Without Chronic Kidney Disease Before Sodium-Glucose Cotransporter Protein 2 Inhibitors: Insights From the Diabetes Mellitus Status in Canada Survey

Nouraei, H.; Leiter, Lawrence A.; Tan, Mary; Langer, Anatoly; Teoh, Hwee; Cheng, Alice; Wald, Ron; Connelly, Kim A.; Goodman, Shaun G.

doi:10.1016/j.jcjd.2021.02.003

Cited by 3 publications

(1 citation statement)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of those with NAFLD, about 20% have non-alcoholic steatohepatitis (NASH), which affects approximately 5% of adults in the U.S. (American Liver Foundation, 2022) (Liver -American Liver Foundation, n.d.). The increased prevalence of NAFLD/NASH in recent years is associated with rises in obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome (Nouraei et al, 2021,) Also, polycystic ovarian syndrome (PCOS) is one of the most common causes of female infertility, affecting 6% to 12% (as many as 5 million) of reproductive-age women in the United States. Women with PCOS are at risk of developing serious health problems such as diabetes, gestational diabetes, heart disease, high blood pressure, high LDL and low HDL cholesterol, sleep apnea, stroke, depression, and anxiety.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Use of Diabetic Medications for Non-Diabetic Conditions: A Comprehensive Literature Review

Iriowen,

Edema,

Dike

et al. 2023

AJHMN

View full text Add to dashboard Cite

Purpose: Currently, a significant portion of the US population has been impacted by diabetes, and alongside it, heart failure, chronic kidney disease (CKD), obesity, and non-alcoholic fatty liver disease (NAFLD) rates are on the rise. Recent research has highlighted the potential of antidiabetic medications to extend beyond diabetes management. This literature review is aimed at exploring the evolving roles of GLP-1 receptor agonists, SGLT2 inhibitors, and thiazolidinediones. It specifically investigates their applications in cardiovascular disease, chronic kidney disease (CKD), obesity, polycystic ovarian syndrome (PCOS), and NAFLD. As a novel therapeutic approach, their application could reshape treatment strategies for interconnected metabolic disorders, offering a new horizon in patient care. Methodology: We conducted a comprehensive search of PubMed and Google Scholar for English-language studies published in the United States and Canada between January 1st, 2013, and August 31st, 2023 focusing on trials involving GLP-1RA, SGLT-2i, and thiazolidinediones therapy. Findings: In our study, GLP-1 receptor agonists emerged as multifaceted pharmaceutical agents, showcasing improvements in cardiovascular disease outcomes, nephroprotective effects, substantial efficacy in obesity management, and promising prospects in addressing non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS). Additionally, thiazolidinediones displayed effectiveness in the management of non-alcoholic steatohepatitis (NASH), while metformin exhibited notable benefits in PCOS management. Furthermore, Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors demonstrated remarkable advancements, particularly in terms of cardiovascular and renal benefits. Our findings emphasize the diverse and evolving applications of diabetic medications in addressing a wide range of chronic medical conditions, ultimately leading to enhanced patient care and improved outcomes. Recommendations: We recommend that healthcare practitioners carefully consider the expanded utility of these medications beyond their conventional diabetic indications and explore their integration into treatment strategies for the indicated medical conditions. This should be done while thoughtfully weighing the associated risks and benefits to ensure the most effective and safe patient care possible.

show abstract

Section: Introductionmentioning

confidence: 99%

Exploring the Use of Diabetic Medications for Non-Diabetic Conditions: A Comprehensive Literature Review

Iriowen,

Edema,

Dike

et al. 2023

AJHMN

View full text Add to dashboard Cite

show abstract

Thiazide diuretics are back in CKD: the case of chlorthalidone

Minutolo

Nicola

Mallamaci

et al. 2022

Clinical Kidney Journal

View full text Add to dashboard Cite

Sodium and volume excess is the fundamental risk factor underlying hypertension in CKD patients that represent the prototypical population characterized by salt-sensitive hypertension. Low salt diets and diuretics constitute the centrepiece for blood pressure control in CKD. In patients with CKD stage 4, loop diuretics are generally preferred to thiazides. Furthermore, thiazide diuretics have long been held as being of limited efficacy in this population. In this review, by systematically appraising published randomized trials of thiazides in CKD, we show that this class of drugs may be useful even among people with advanced CKD. Thiazides cause a negative sodium balance and reduce body fluids by 1-2 L within the first 2-4 weeks and these effects go along with improvement in hypertension control. The recent CLICK trial has documented the antihypertensive efficacy of chlorthalidone, a long-acting thiazide-like diuretic, in stage 4 CKD patients with poorly controlled hypertension. Overall, chlorthalidone use could be considered in patients with treatment-resistant hypertension when spironolactone cannot be administered or must be withdrawn due to side effects. Hyponatremia, hypokalaemia, volume depletion, and acute kidney injury are side effects that demand a vigilant attitude by physicians prescribing these drugs. Well-powered randomized trials assessing hard outcomes are still necessary for more confidently recommending the use of these drugs in advanced CKD.

show abstract

Prevalence of nephropathy among diabetic patients in North American region: A systematic review and meta-analysis

Zahra,

Saleem,

Ejaz

et al. 2024

Medicine

View full text Add to dashboard Cite

Background: Nephropathy is one of the most common microvascular impediments of diabetes mellitus. In this study, we aimed to estimate the prevalence of nephropathy in diabetic patients across the North American region. Methods: Eligible studies were screened out from 3 electronic databases, for example, PubMed, Google Scholar, and ScienceDirect using specific search keywords based on the eligibility criteria. Extracting the data from the included studies publication bias, quality assessment, outlier investigation, and meta-analysis was done followed by the subgroup analysis. A total of 11 studies met the study inclusion criteria. Meta-analysis was performed with the extracted data. Results: Pooled prevalence of 28.2% (95% confidence interval [CI]: 19.7–36.7) with a high rate of heterogeneity (I 2 = 100%) was identified. The pooled prevalence of nephropathy among diabetic patients in the United States of America, Canada, and Mexico was 24.2% (95% CI: 13.8–34.5), 31.2% (95% CI: 25.8–36.5), and 31.1% (95% CI: 20.8–41.5), respectively. Conclusion: The prevalence of nephropathy among diabetic patients was found lower in the United States of America as compared to Canada and Mexico. Besides, the pooled prevalence of the North American region was found to be lower as compared to the African, European, and Asian regions. Minimizing the pathogenic factors, sufficient diagnostic, healthcare facilities, and awareness are recommended to improve the situation.

show abstract

Glycemic Control and Cardiovascular Risk Factor Management in Adults With Type 2 Diabetes With and Without Chronic Kidney Disease Before Sodium-Glucose Cotransporter Protein 2 Inhibitors: Insights From the Diabetes Mellitus Status in Canada Survey

Abstract: Only 1 of 8 patients with diabetes in the community achieve guideline-recommended glycemic, blood pressure and cholesterol targets. Patients with diabetes and chronic kidney disease may require special attention to optimize risk factor control.

Cited by 3 publications

References 37 publications

Exploring the Use of Diabetic Medications for Non-Diabetic Conditions: A Comprehensive Literature Review

Exploring the Use of Diabetic Medications for Non-Diabetic Conditions: A Comprehensive Literature Review

Thiazide diuretics are back in CKD: the case of chlorthalidone

Prevalence of nephropathy among diabetic patients in North American region: A systematic review and meta-analysis

Contact Info

Product

Resources

About