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Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
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Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
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α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
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SGLT2 inhibitors reduce all-cause mortality.

Orly F Kohn1

  • 1The University of Chicago, Chicago, Illinois, USA (O.F.K.).

Annals of Internal Medicine
|May 3, 2021
PubMed
Summary

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) show a significant reduction in all-cause mortality in patients with type 2 diabetes. This meta-analysis confirms their life-extending benefits in cardiovascular risk management.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are a class of antidiabetic drugs.
  • SGLT2i have demonstrated cardiovascular and renal benefits.
  • The impact of SGLT2i on all-cause mortality requires comprehensive evaluation.

Purpose of the Study:

  • To conduct a meta-analysis of randomized controlled trials (RCTs).
  • To assess the effect of SGLT2 inhibitors on all-cause mortality.
  • To evaluate the safety and efficacy of SGLT2 inhibitors in diverse patient populations.

Main Methods:

  • Systematic literature search of RCTs involving SGLT2 inhibitors.
  • Inclusion of studies reporting all-cause mortality as an outcome.
  • Meta-analysis using appropriate statistical models to pool data.

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Main Results:

  • SGLT2 inhibitors significantly reduced all-cause mortality compared to placebo.
  • The observed mortality benefit was consistent across different SGLT2 inhibitor agents.
  • No significant increase in adverse events was associated with SGLT2 inhibitors.

Conclusions:

  • SGLT2 inhibitors are associated with a significant reduction in all-cause mortality.
  • These findings support the use of SGLT2 inhibitors for improving survival in patients with type 2 diabetes.
  • Further research should explore the mechanisms underlying the mortality benefit.