Related Experiment Video

Updated: Jul 11, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.9K

Bridging the gap in cardiovascular care in diabetic patients: are cardioprotective antihyperglycemic agents

André J Scheen1,2

  • 1Division of Clinical Pharmacology, Centre for Interdisciplinary Research on Medicines (CIRM), Liège University, Liège, Belgium.

Expert Review of Clinical Pharmacology
|November 3, 2023
PubMed

Insights

Cardiovascular protection in type 2 diabetes (T2DM) is suboptimal. Despite proven benefits of GLP-1RAs and SGLT2is, uptake remains low, necessitating interventions to improve use in T2DM patients.

Area of Science:

  • Endocrinology and Cardiology
  • Pharmacology

Background:

  • Type 2 diabetes (T2DM) significantly increases risks of atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF).
  • Cardiovascular protection is a primary treatment goal in T2DM but remains incompletely achieved in clinical practice.

Purpose of the Study:

  • To highlight the underutilization of cardioprotective medications in T2DM.
  • To emphasize the need for bridging the gap between evidence and clinical practice regarding GLP-1RAs and SGLT2is.

Main Methods:

  • Review of clinical trial data demonstrating efficacy of GLP-1RAs and SGLT2is.
  • Analysis of real-world data indicating low prescription rates of these agents in T2DM patients, particularly those with established ASCVD or HF.

Main Results:

  • GLP-1 receptor agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2is) are effective in reducing cardiovascular events and HF hospitalizations in T2DM.
  • A significant disparity exists between the proven benefits and the low uptake of GLP-1RAs and SGLT2is in routine T2DM care worldwide.
  • Patients with established ASCVD or HF have even lower rates of treatment with these cardioprotective agents.

Conclusions:

  • Addressing the underuse of GLP-1RAs and SGLT2is in T2DM is a critical public health issue.
  • Current strategies have failed to bridge the evidence-practice gap, requiring new approaches.
  • Multifaceted interventions involving healthcare professionals, patients, and the healthcare system are essential to promote the adoption of these medications for cardiovascular risk reduction in T2DM.
Abstract

Keywords:
Atherosclerotic cardiovascular diseaseGLP-1 receptor agonistSGLT2 inhibitorcardiovascular outcome trialgliflozinheart failurereal-world clinical practice

More Related Videos

Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model06:22

Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model

Published on: November 29, 2024

631
Mouse Electroacupuncture Fixation Device Fabrication for Electroacupuncture Pretreatment in Diabetic Cardiomyopathy Mouse Model05:58

Mouse Electroacupuncture Fixation Device Fabrication for Electroacupuncture Pretreatment in Diabetic Cardiomyopathy Mouse Model

Published on: April 18, 2025

191

Related Concept Videos

Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

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...
212
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
438
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
290
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
400
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
598
Carbohydrate Metabolism01:36

Carbohydrate Metabolism

Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
11.2K