Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Davies, Melanie J.; D’Alessio, David A.; Fradkin, Judith; Kernan, Walter N.; Mathieu, Chantal; Mingrone, Geltrude; Rossing, Peter; Τσάπας, Απόστολος; Wexler, Deborah J.; Buse, John B.

doi:10.2337/dci18-0033

Cited by 2,524 publications

(2,768 citation statements)

References 241 publications

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“…In the present study, switching from exenatide b.i.d., a short‐acting GLP‐1RA, to exenatide q.w., a long‐acting GLP‐1RA, resulted in the reduction of FPG and HbA1c levels without increasing the incidence of hypoglycemia, and improved treatment satisfaction in Japanese patients with type 2 diabetes. A recent meta‐analysis of CVD outcomes trials has shown a CVD protective effect of GLP‐1RAs, and the updated American Diabetes Association/European Association for the Study of Diabetes guidelines for the management of type 2 diabetes recommend the use of GLP‐1RAs for patients with type 2 diabetes and CVD; however, heterogeneity of the CVD protective effect among the approved GLP‐1RAs has also been suggested.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of once‐weekly exenatide after switching from twice‐daily exenatide in patients with type 2 diabetes

Watanabe

Saisho

Inaishi

et al. 2019

J of Diabetes Invest

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Aims/Introduction To evaluate the efficacy and safety of once‐weekly (q.w.) extended‐release exenatide after switching from twice‐daily (b.i.d.) exenatide in patients with type 2 diabetes. Materials and Methods This was an investigator‐initiated, prospective, single‐arm, multicenter study. Individuals with type 2 diabetes who had been treated with exenatide b.i.d. for at least 3 months were enrolled and switched to exenatide q.w. for 24 weeks. The primary end‐point was change in HbA1c at week 24 to test the glucose‐lowering effect of exenatide q.w. versus exenatide b.i.d. Results A total of 58 Japanese individuals with type 2 diabetes completed the study. Glycated hemoglobin was reduced by 0.2% at week 24 (7.2 ± 1.2% vs 7.0 ± 1.2% [56 ± 13 vs 53 ± 13 mmol/mol], 95% confidence interval −0.4 to −0.03%, P < 0.005 for non‐inferiority, P = 0.01 for superiority). Fasting plasma glucose was reduced by 12 mg/dL at week 24 (154 ± 46 vs 142 ± 46 mg/dL, P = 0.02). β‐Cell function assessed by homeostasis model assessment of β‐cell function and C‐peptide index was significantly improved at week 24. The incidence of self‐reported hypoglycemia was reduced, and treatment satisfaction assessed by the Diabetes Treatment Satisfaction Questionnaire and Diabetes Medication Satisfaction Questionnaire was improved at week 24, with no change in body weight. There was no serious adverse event related to the study drug. Conclusions Switching from exenatide b.i.d. to exenatide q.w. resulted in a reduction in glycated hemoglobin, fasting plasma glucose and the incidence of hypoglycemia, and improvement in β‐cell function and treatment satisfaction in patients with type 2 diabetes. These findings will be useful for selecting optimal treatment in individuals with type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

“…In addition to their glucose‐lowering effect, effects on weight and the incidence of hypoglycemia are also important components of antidiabetic medication. It has been reported that treatment with exenatide b.i.d.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of once‐weekly exenatide after switching from twice‐daily exenatide in patients with type 2 diabetes

Watanabe

Saisho

Inaishi

et al. 2019

J of Diabetes Invest

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“…While observations of increased CVD events and raised mortality have questioned the use of sulphonylureas either as monotherapy or in combination with metformin vs. other glucose-lowering agents [24–27], some meta-analyses and systematic reviews have provided reassurance on the CV safety of this drug class [28, 29], alongside the ADVANCE study [15], and the recent announcement of the non-inferiority results of the CAROLINA study [30]. Despite this, with more favourable CV profiles of newer agents emerging, ADA/EASD guidelines have shifted away from recommending the early use of sulphonylureas in patients with established CVD [31]. …”

Section: Modifying Cardiovascular Risk In T2dmmentioning

confidence: 99%

“…A summary of recommendations from Australian as well as several international guidelines is outlined in BOX 1 [31, 34–38]. …”

Section: Modifying Cardiovascular Risk In T2dmmentioning

confidence: 99%

Managing Cardiovascular Risk in Type 2 Diabetes: What Do the Cardiovascular Outcome Trials Mean for Australian Practice?

et al. 2019

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Understanding the implications of cardiovascular (CV) outcomes data of glucose-lowering agents on the management of type 2 diabetes mellitus can be challenging for many primary practitioners. Amongst different classes of diabetes medications assessed for CV safety, several agents within the sodium-glucose transport protein-2 inhibitor and glucagon-like peptide-1 receptor agonists classes have demonstrated CV risk reduction. Applying the trial findings to patients typically seen in clinical practice, such as those with established CV disease and those with multiple CV risk factors without established CV disease, requires further clarity. To bridge this gap in our current knowledge, the aim of this review was to utilise expert-driven opinions on common case scenarios and practical recommendations on the most appropriate choice of agents, according to an individual patient’s clinical risk profile (CV and kidney disease), treatment preference and reimbursement environment from an Australian perspective.Funding: Boehringer Ingelheim Australia.

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“…In a consensus report by the American Diabetes Association and the European Association for the Study of Diabetes on managing patients with hyperglycemia, sodium–glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with type 2 diabetes and chronic kidney disease (CKD), because they showed beneficial effects on the renal end‐points, albeit as secondary outcomes, in large cardiovascular outcomes trials, such as Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients Removing Excess Glucose, Canagliflozin Cardiovascular Assessment Study and Dapagliflozin Effect on Cardiovascular Events ‐ Thrombolysis in Myocardial Infarction 58. The protective effects of SGLT2i on renal function were observed in albuminuria and in the renal hard end‐points including a ≥40% decrease in eGFR to <60 mL/min/1.73 m 2 , new ESKD, or death from renal or cardiovascular causes, and the effects were consistent in all three SGLT2i trials.…”

Section: Introductionmentioning

confidence: 99%

Protective effect of sodium–glucose cotransporter 2 inhibitors in patients with rapid renal function decline, stage G3 or G4 chronic kidney disease and type 2 diabetes

Miyoshi

Kameda

Yamashita³

et al. 2019

J of Diabetes Invest

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Aims/Introduction The risk of end‐stage kidney disease increases in proportion to the decline in the estimated glomerular filtration rate (eGFR). Although protective effects of sodium–glucose cotransporter 2 inhibitors (SGLT2i) on the eGFR decline were shown in several large‐scale clinical trials, there are no studies investigating patients with a high risk of end‐stage kidney disease. We investigated the efficacy and safety of SGLT2i in advanced renal dysfunction patients (stage G3 or G4 of chronic kidney disease) with a rapid decline in eGFR. Materials and Methods This retrospective, longitudinal study enrolled patients with type 2 diabetes who were treated with SGLT2i, and whose eGFR was <60 mL/min/1.73 m2 and had declined >20% over 2 years (%ΔeGFR−2y) before initiating SGLT2i. The primary end‐point was the change in eGFR 2 years after initiation (%ΔeGFR+2y) compared with %ΔeGFR−2y. Results A total of 17 patients among 553 patients treated with SGLT2i for ≥2 years were included in the study. The average age, glycated hemoglobin and eGFR at SGLT2i initiation were 68.5 years, 7.3% and 38.3 mL/min/1.73 m2, respectively. %ΔeGFR+2y in patients who were treated with SGLT2i was significantly increased compared with the patients not treated with SGLT2i (2.3 and −21.7%, respectively; P < 0.0001). A multiple regression analysis showed that only the proportion of the rate of eGFR decline was the independent factor associated with improvement of %ΔeGFR+2y. There was no increase in serious adverse events including acute kidney injury. Conclusions SGLT2i was safe, and prevented further eGFR decline in patients with type 2 diabetes and advanced renal dysfunction.

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Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Cited by 2,524 publications

References 241 publications

Efficacy and safety of once‐weekly exenatide after switching from twice‐daily exenatide in patients with type 2 diabetes

Efficacy and safety of once‐weekly exenatide after switching from twice‐daily exenatide in patients with type 2 diabetes

Managing Cardiovascular Risk in Type 2 Diabetes: What Do the Cardiovascular Outcome Trials Mean for Australian Practice?

Protective effect of sodium–glucose cotransporter 2 inhibitors in patients with rapid renal function decline, stage G3 or G4 chronic kidney disease and type 2 diabetes

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