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Glucose-Lowering Medications and Cardiovascular Outcomes
Madhan Shanmugasundaram1, J R Exequiel Pineda2, Sangeetha Murugapandian3
1Sarver Heart Center, Section of Cardiology, University of Arizona College of Medicine, 1501 N Campbell Avenue, Tucson, AZ, 85724, USA. msundaram@shc.arizona.edu.
Current Cardiology Reports
|March 3, 2021
Summary
Newer diabetes medications, including SGLT2 inhibitors and GLP-1 RAs, demonstrate cardiovascular safety and improve outcomes. These drugs are recommended for type 2 diabetes patients with existing cardiovascular disease or risk factors.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Diabetes mellitus (DM) significantly increases cardiovascular disease (CVD) risk.
- The FDA mandates cardiovascular safety assessments for new diabetes medications since 2008.
- Effective CVD management is crucial for diabetic patients.
Purpose of the Study:
- To review current evidence on the cardiovascular (CV) safety of newer diabetes medication classes.
- To examine the impact of these medications on improving CV outcomes.
Main Methods:
- Literature review of recent studies and FDA mandates.
- Analysis of data on Dipeptidyl peptidase-4 (DPP-4) inhibitors, Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and Sodium-glucose cotransporter type 2 (SGLT-2) inhibitors.
- Evaluation of CV safety and outcome improvement data.
Main Results:
- DPP-4 inhibitors, GLP-1 RAs, and SGLT-2 inhibitors have established CV safety.
- Certain drugs within GLP-1 RA and SGLT-2 inhibitor classes show proven CV outcome benefits.
- Recommendations exist for using SGLT-2 inhibitors or GLP-1 RAs with demonstrated CV benefit in high-risk patients.
Conclusions:
- Newer diabetes drug classes offer significant CV safety and outcome benefits.
- SGLT-2 inhibitors and GLP-1 RAs are valuable therapeutic options for managing cardiovascular risk in type 2 diabetes.
- These medications represent a major advancement in comprehensive diabetes care.
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