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Treatment of type 2 diabetes patients with heart conditions

Gulali Aktas1, Burcin Meryem Atak Tel1, Ramiz Tel2

  • 1Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey.

Expert Review of Endocrinology & Metabolism
|April 20, 2023
PubMed

Insights

Type 2 diabetes mellitus (T2DM) management requires careful consideration of cardiac risks. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are recommended for diabetic patients with heart failure due to proven cardiovascular benefits.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) significantly elevates the risk of cardiac complications.
  • Diabetes treatment strategies can influence the incidence of cardiac events, necessitating careful selection of therapies for patients with co-existing cardiac conditions.

Approach:

  • This review synthesizes current evidence on anti-diabetic medications in patients with cardiac conditions.
  • It analyzes clinical trials and meta-analyses focusing on the cardiac safety and efficacy of various anti-diabetic agents.
  • Recommendations are based on findings from recent medical literature, including meta-analyses and cardiac safety studies.

Key Points:

  • Hypoglycemia and extreme hyperglycemia must be avoided in acute ischemic heart conditions.
  • Sodium-glucose cotransporter-2 (SGLT2) inhibitors demonstrate a reduction in cardiovascular mortality and heart failure hospitalizations.
  • Metformin and pioglitazone may decrease the risk of atrial fibrillation (AF) in diabetic individuals.

Conclusions:

  • SGLT2 inhibitors should be considered a first-line treatment for diabetic patients with heart failure or at high risk of developing it.
  • Careful selection of anti-diabetic medications is crucial for managing patients with T2DM and cardiac conditions.
  • Further research may explore the long-term cardiovascular outcomes associated with different anti-diabetic drug classes.
Abstract

Keywords:
Type 2 diabetes mellitusatrial fibrillationcardiac conditionsdiabetes treatmentheart failure

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