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Cardiovascular Effects of Hypoglycemic Agents in Diabetes Mellitus

Anna Pietraszek1

  • 1Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Aalborg, Denmark.

Current Drug Safety
|September 4, 2020
PubMed

Insights

Metformin, glucagon-like 1 receptor antagonists, and sodium-glucose transporter 2 inhibitors show cardiovascular benefits in diabetes management. These agents offer primary and secondary prevention for cardiovascular disease and heart failure, with careful monitoring for side effects like ketoacidosis.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus remains a significant risk factor for cardiovascular disease, heart failure, and mortality.
  • Despite advancements, managing cardiovascular complications in diabetic patients is crucial.

Purpose of the Study:

  • To review data on reducing cardiovascular morbidity and mortality in diabetes.
  • To examine glucose-independent cardiovascular effects of antidiabetic medications, excluding insulin.

Main Methods:

  • Narrative review of recent reviews and meta-analyses.
  • Inclusion of individual trial data where relevant.

Main Results:

  • Metformin demonstrates a consistent cardioprotective role.
  • Cardiovascular effects of thiazolidinediones, sulfonylureas, and glinides are uncertain.
  • Dipeptidyl peptidase 4 inhibitors show a neutral cardiovascular profile.
  • Glucagon-like 1 receptor antagonists and sodium-glucose transporter 2 inhibitors offer compelling cardioprotective evidence.

Conclusions:

  • Metformin is beneficial for primary and secondary cardiovascular disease prevention.
  • Glucagon-like 1 receptor antagonists and sodium-glucose transporter 2 inhibitors are vital for secondary prevention of atherosclerotic cardiovascular disease.
  • Sodium-glucose transporter 2 inhibitors are indicated for primary and secondary heart failure prevention, with a risk of euglycemic diabetic ketoacidosis.
Abstract

Keywords:
antidiabeticglinidessulphonylureaMetformincardioprotectionglycaemia

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