SGLT2 inhibitors and GLP-1 receptor agonists: established and emerging indications

Brown, Emily; Heerspink, Hiddo J L; Cuthbertson, Daniel J; Wilding, John

doi:10.1016/s0140-6736(21)00536-5

Cited by 328 publications

(248 citation statements)

References 89 publications

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“…Glucagon-like peptide-1 agonist and sodium-glucose cotransporter-2 inhibitors are drugs used in T2DM as glucose-lowering agents. They have also shown improvement in blood pressure control, weight loss, and cardioprotective in atherosclerotic disease [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

Significance of Educational Literature and Diabetes Log Sheet on Hemoglobin A1c

Padda¹,

Khalid²,

Zubair³

et al. 2022

Cureus

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Diabetes mellitus (DM) is a major cause of morbidity worldwide. The prevalence of DM has doubled over the last 35 years and is escalating. Various complications and manifestations of diabetes have caused numerous deaths worldwide, with numbers increasing every year. There have been many advances and breakthroughs over the past decade in the management of DM. The major focus of many research studies has been to evaluate effective medication combinations, preventative measures, and the way to control such morbid conditions. Our focus in this review is to discuss specific secondary prevention techniques with the diabetes log sheet and educational literature on its effectiveness in controlling diabetes. Hemoglobin A1c (HbA1c) has been accepted as a diabetes control measure in many resources worldwide. Here, we have assessed articles on the effectiveness of the diabetes log sheet and educational literature on HbA1c levels. We will begin with a few key points to acknowledge diabetes initially, followed by discussing the effectiveness of the diabetes log sheet and literature on HbA1c.

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Section: Reviewmentioning

confidence: 99%

Significance of Educational Literature and Diabetes Log Sheet on Hemoglobin A1c

Padda¹,

Khalid²,

Zubair³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Several studies have reported that GLP‐1 or GLP‐1 analogues can cause weight loss in animals and humans. 53 , 54 The mechanisms are likely attributed to decreased energy intake (e.g. delayed gastric emptying, gastric secretion, and motility), appetite sensation, increased energy expenditure, and perception of satiety.…”

Section: Effects Of Anti‐diabetic Drugs On the Musclementioning

confidence: 99%

Anti‐diabetic drugs and sarcopenia: emerging links, mechanistic insights, and clinical implications

Zhang

Zhao

Chen

et al. 2021

J cachexia sarcopenia muscle

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Sarcopenia, characterized by loss of skeletal muscle mass, quality, and strength, has become a common hallmark of ageing and many chronic diseases. Diabetes mellitus patients have a higher prevalence of sarcopenia, which greatly aggravates the metabolic disturbance and compromises treatment response. Preclinical and clinical studies have shown differential impacts of anti‐diabetic drugs on skeletal muscle mass, strength, and performance, highlighting the importance of rational therapeutic regimen from the perspective of sarcopenia risk. In this review, we provide an update on the regulation of muscle mass and quality by major anti‐diabetic drugs, focusing primarily on emerging data from clinical studies. We also discuss the underlying mechanisms and clinical implications for optimal selection of anti‐diabetic drugs to reduce the risk of sarcopenia. In view of the lifelong use of anti‐diabetic drugs, we propose that a better understanding of the sarcopenia risk and interventional strategies is worthy of attention in future studies.

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“…[9][10][11][12][13] As such, glucose-lowering medications have been shown to be efficacious for improving HF outcomes in diabetic patients, especially in diabetic patients with high risk or established cardiovascular disease. 14,15 Furthermore, results from multiple meta-analyses have also showed the superiority of glucose-lowering medications over placebo in improving outcomes for diabetic HF patients. GLP1-RA and SGLT2i demonstrated significant cardiovascular benefits, 16,17 while SGLT2i were more superior for improving HF outcomes and reduce hospitalizations for HF.…”

Section: Introductionmentioning

confidence: 99%

Can glucose‐lowering medications improve outcomes in non‐diabetic heart failure patients? A Bayesian network meta‐analysis

et al. 2022

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AimsThe cardioprotective effects of glucose-lowering medications in diabetic patients with heart failure (HF) are well known. Several large randomized controlled trials (RCTs) have recently suggested that the cardioprotective effects of glucose-lowering medications extend to HF patients regardless of diabetic status. The aim of this study was to conduct a Bayesian network meta-analysis to evaluate the impact of various glucose-lowering medications on the outcomes of non-diabetic HF patients. Methods and results Medline and Embase were searched for RCTs investigating the use of glucose-lowering medications in non-diabetic HF patients in August 2021. Studies were included in accordance with the inclusion and exclusion criteria, and data were extracted with a pre-defined datasheet. Primary outcomes include serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, left ventricular ejection fraction (LVEF), and maximal oxygen consumption (PVO 2 ). A Bayesian network meta-analysis was performed to compare the effectiveness of different classes of glucose-lowering medications in improving HF outcomes. Risk-of-bias was assessed using Cochrane Risk-of-Bias tool 2.0 for randomized trials (ROB2). Seven RCTs involving 2897 patients were included. Sodium-glucose transporter 2 inhibitor (SGLT2i) was the most favourable in lowering NT-proBNP, with the significant reduction in NT-proBNP when compared with glucagon-like peptide-1 receptor agonists (GLP1-RA) [mean differences (MD): À229.59 pg/mL, 95%-credible intervals (95%-CrI): À238.31 to À220.91], metformin (MD: À237.15 pg/mL, 95%-CrI: À256.19 to À218.14), and placebo (MD: À228.00 pg/mL, 95%-CrI: À233.99 to À221.99). SGLT2i was more effective in improving LVEF for HF with reduced ejection fraction patients relative to GLP1-RA (MD: 8.09%, 95%-CrI: 6.30 to 9.88) and placebo (MD: 6.10%, 95%-CrI: 4.37 to 7.84). SGLT2i and GLP1-RA were more favourable to placebo in improving PVO 2 , with significant increase of PVO 2 at a MD of 1.60 mL/kg/min (95%-CrI: 0.63 to 2.57) and 0.86 mL/kg/min (95%-CrI: 0.66 to 1.06), respectively. All three drugs had comparable safety profiles when compared with placebo. Conclusions This Bayesian network meta-analysis demonstrated that SGLT2i, when compared with GLP1-RA and metformin, was superior in improving LVEF in HF with reduced ejection fraction patients, as well as improving PVO 2 and NT-proBNP in non-diabetic HF patients. Further large-scale prospective studies are needed to confirm these preliminary findings.

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SGLT2 inhibitors and GLP-1 receptor agonists: established and emerging indications

Cited by 328 publications

References 89 publications

Significance of Educational Literature and Diabetes Log Sheet on Hemoglobin A1c

Significance of Educational Literature and Diabetes Log Sheet on Hemoglobin A1c

Anti‐diabetic drugs and sarcopenia: emerging links, mechanistic insights, and clinical implications

Can glucose‐lowering medications improve outcomes in non‐diabetic heart failure patients? A Bayesian network meta‐analysis

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