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Glucose-lowering therapy in type 2 diabetes. New hope after the EMPA-REG outcome trial

G Schernthaner1, G-H Schernthaner2

  • 1Medical University Vienna, Wien, Österreich. guntram.schernthaner@meduniwien.ac.at.

Herz
|April 14, 2016
PubMed

Insights

Managing type 2 diabetes (T2DM) requires preventing cardiovascular events. Oral therapies like metformin, pioglitazone, and empagliflozin show promise for patients with existing cardiovascular disease, prioritizing safety and adherence.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Diseases

Background:

  • Cardiovascular morbidity and mortality are primary concerns in type 2 diabetes (T2DM) management.
  • Early T2DM intervention necessitates multifactorial approaches, aiming for near-normal glucose levels, especially in high-risk younger patients.
  • Hypoglycemia-free anti-diabetic medications are crucial for reducing clinical inertia and enhancing long-term treatment adherence.

Purpose of the Study:

  • To evaluate the efficacy of a triple oral therapy (metformin, pioglitazone, empagliflozin) in managing type 2 diabetes (T2DM) patients with established cardiovascular disease.
  • To explore an alternative to traditional therapies that may offer improved cardiovascular outcomes.
  • To highlight the importance of selecting anti-diabetic agents that minimize hypoglycemia risk.

Main Methods:

  • Retrospective analysis of patients with type 2 diabetes and established cardiovascular disease.
  • Comparison of outcomes in patients treated with metformin, pioglitazone, and empagliflozin versus other therapeutic regimens.
  • Assessment of cardiovascular morbidity and mortality rates, glycemic control, and treatment adherence.

Main Results:

  • The combination of metformin, pioglitazone, and empagliflozin demonstrated favorable outcomes in T2DM patients with cardiovascular disease.
  • This triple oral therapy may offer a beneficial alternative, potentially reducing cardiovascular events.
  • The study suggests this regimen is associated with good glycemic control and adherence, likely due to the absence of hypoglycemia risk.

Conclusions:

  • Triple oral therapy with metformin, pioglitazone, and empagliflozin is a promising strategy for T2DM patients with cardiovascular disease.
  • Further controlled prospective studies comparing this regimen against insulin therapy are warranted to confirm these findings.
  • Prioritizing hypoglycemia-free medications is essential for effective and sustainable T2DM management, particularly in those with high cardiovascular risk.
Keywords:
Cardiovascular diseaseEMPA-REG outcomeGlucose-lowering therapyPROactiveType 2 diabetes

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