Redefining diabetes mellitus treatments according to different mechanisms beyond hypoglycaemic effect.
Cardiovascular risk
Diabetes mellitus
GLP-1RAs
Hyperglicemia
Metabolic syndrome
SGLT2i
Journal
Heart failure reviews
ISSN: 1573-7322
Titre abrégé: Heart Fail Rev
Pays: United States
ID NLM: 9612481
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
accepted:
09
12
2021
medline:
1
5
2023
pubmed:
9
2
2022
entrez:
8
2
2022
Statut:
ppublish
Résumé
Early epidemiologic studies in type 2 diabetes suggested that the long-term risk of microvascular and macrovascular complications increase progressively as glucose concentrations rise, inspiring the pursuit of near euglycaemia as a means of preventing these complications in type 1 and type 2 diabetes. Evidence emerging over the past decade, however, showed that the aggressive efforts often needed to achieve low HbA1c levels can ultimately lead to worse clinical outcomes, greater risk of severe hypoglycaemia, and higher burden of treatment. The acknowledgment of the disappointing results obtained with therapies aimed exclusively at improving glycaemic control has led in recent years to a substantial paradigm shift in the treatment of the diabetic patient. The results obtained first with GLP-1RAs and more recently even more with SGLT2i on mortality and CV events have made it clear how other mechanisms, beyond the hypoglycaemic effect, are at the basis of the benefits observed in several cardiovascular outcome trials. And as evidence of the great revolution of thought we are experiencing, there is the recognition of gliflozins as drugs for the treatment not only of diabetic patients but also of non-diabetic patients suffering from HF, as reported in the latest ESC/HFA guidelines. Surely, we still have a lot to understand, but it is certain that this is the beginning of a new era.
Identifiants
pubmed: 35133551
doi: 10.1007/s10741-021-10203-9
pii: 10.1007/s10741-021-10203-9
pmc: PMC8821791
doi:
Substances chimiques
Hypoglycemic Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
607-625Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Endocrinology. 2003 Sep;144(9):3848-51
pubmed: 12933657
Prog Cardiovasc Dis. 2020 May - Jun;63(3):249-262
pubmed: 32275926
N Engl J Med. 2016 Nov 10;375(19):1834-1844
pubmed: 27633186
Circulation. 2018 Jan 9;137(2):119-129
pubmed: 28904068
Lancet. 2020 Sep 19;396(10254):819-829
pubmed: 32877652
Lancet. 2019 Jul 13;394(10193):121-130
pubmed: 31189511
Biomedicines. 2020 Feb 25;8(3):
pubmed: 32106580
Heart Fail Rev. 2022 Jul;27(4):1147-1163
pubmed: 34097173
BMJ. 2011 Nov 24;343:d6898
pubmed: 22115901
N Engl J Med. 1993 Sep 30;329(14):977-86
pubmed: 8366922
N Engl J Med. 2011 Mar 3;364(9):818-28
pubmed: 21366473
Diabetes Obes Metab. 2013 Jul;15(7):668-73
pubmed: 23489301
Circ Res. 2018 May 11;122(10):1439-1459
pubmed: 29748368
Cardiovasc Diabetol. 2018 Jan 8;17(1):8
pubmed: 29310645
Nutr Metab Cardiovasc Dis. 2020 Jun 25;30(7):1106-1114
pubmed: 32448716
Cardiovasc Diabetol. 2018 Nov 1;17(1):140
pubmed: 30384842
Lancet. 2014 Jun 7;383(9933):2008-17
pubmed: 24910232
Lancet. 2015 May 23;385(9982):2107-17
pubmed: 26009231
Cardiovasc Diabetol. 2020 Jun 26;19(1):98
pubmed: 32590982
Cardiovasc Diabetol. 2019 Aug 28;18(1):112
pubmed: 31462224
Clin Med (Lond). 2009 Aug;9(4):353-7
pubmed: 19728510
N Engl J Med. 2020 Oct 8;383(15):1436-1446
pubmed: 32970396
Eur Heart J. 2020 Jan 7;41(2):255-323
pubmed: 31497854
Lancet. 2018 Oct 27;392(10157):1519-1529
pubmed: 30291013
N Engl J Med. 2020 Oct 8;383(15):1413-1424
pubmed: 32865377
Eur J Heart Fail. 2021 Jul;23(7):1217-1225
pubmed: 34051124
Lancet. 1998 Sep 12;352(9131):837-53
pubmed: 9742976
Eur J Heart Fail. 2020 Sep;22(9):1495-1503
pubmed: 32618086
JAMA. 2020 Apr 14;323(14):1353-1368
pubmed: 32219386
Cardiovasc Diabetol. 2018 Apr 10;17(1):53
pubmed: 29636047
N Engl J Med. 2019 Aug 29;381(9):841-851
pubmed: 31185157
Eur J Pharmacol. 2004 Feb 20;486(2):121-31
pubmed: 14975701
N Engl J Med. 2017 Aug 17;377(7):644-657
pubmed: 28605608
Circulation. 2014 Oct 28;130(18):1579-88
pubmed: 25189213
BMJ. 2019 Nov 5;367:l5887
pubmed: 31690574
Heart Fail Rev. 2017 Nov;22(6):889-902
pubmed: 28762019
Circulation. 2018 Jul 31;138(5):458-468
pubmed: 29526832
Diabetes Res Clin Pract. 2019 Sep;155:107785
pubmed: 31326453
Diabetes Obes Metab. 2016 Mar;18(3):295-9
pubmed: 26510994
N Engl J Med. 2019 Jun 13;380(24):2295-2306
pubmed: 30990260
J Cardiol. 2019 Jan;73(1):28-32
pubmed: 30318179
Am J Physiol Regul Integr Comp Physiol. 2013 Dec 15;305(12):R1411-20
pubmed: 24005254
Circulation. 2019 Aug 27;140(9):739-750
pubmed: 31291786
BMJ. 2011 Jul 26;343:d4169
pubmed: 21791495
Am Heart J. 2021 Feb;232:10-22
pubmed: 33214130
J Am Med Assoc. 1952 Nov 8;150(10):964-9
pubmed: 12990325
Hypertension. 2003 Feb;41(2):373-7
pubmed: 12574110
Diabetes Care. 2003 Jan;26 Suppl 1:S33-50
pubmed: 12502618
Clin Ther. 2000 Aug;22(8):899-910; discussion 898
pubmed: 10972628
Lancet Diabetes Endocrinol. 2018 Sep;6(9):691-704
pubmed: 29937267
Int J Cardiol. 2017 Mar 1;230:324-326
pubmed: 28043676
Front Endocrinol (Lausanne). 2020 Apr 15;11:190
pubmed: 32351447
Am J Cardiovasc Drugs. 2017 Apr;17(2):143-155
pubmed: 27873238
Lancet Diabetes Endocrinol. 2019 Oct;7(10):776-785
pubmed: 31422062
JAMA Intern Med. 2014 Aug;174(8):1227-34
pubmed: 24979148
Diabetes Care. 2014;37(3):634-43
pubmed: 24170759
N Engl J Med. 2021 Jan 14;384(2):117-128
pubmed: 33200892
N Engl J Med. 2021 Oct 14;385(16):1451-1461
pubmed: 34449189
BMJ. 2021 Jan 13;372:m4573
pubmed: 33441402
Fed Pract. 2018 Jul;35(7):45-48
pubmed: 30766374
N Engl J Med. 2020 Oct 8;383(15):1425-1435
pubmed: 32966714
N Engl J Med. 2016 Jul 28;375(4):311-22
pubmed: 27295427
Lancet. 2019 Jul 13;394(10193):131-138
pubmed: 31189509
N Engl J Med. 2019 Nov 21;381(21):1995-2008
pubmed: 31535829
N Engl J Med. 2021 Jan 14;384(2):129-139
pubmed: 33200891
N Engl J Med. 2015 Dec 3;373(23):2247-57
pubmed: 26630143
Diabetes Obes Metab. 2018 Mar;20(3):479-487
pubmed: 29024278
Life Sci. 2019 Aug 15;231:116538
pubmed: 31176776
Cardiovasc Diabetol. 2014 Feb 04;13:33
pubmed: 24490835
Postgrad Med. 2017 Mar;129(2):205-215
pubmed: 27813442
N Engl J Med. 2017 Sep 28;377(13):1228-1239
pubmed: 28910237
BMJ. 2000 Aug 12;321(7258):405-12
pubmed: 10938048
Cardiovasc Diabetol. 2012 Jan 10;11:3
pubmed: 22234149
Diabetes. 1956 Sep-Oct;5(5):397-405
pubmed: 13365481
N Engl J Med. 2018 Aug 16;379(7):633-644
pubmed: 30110583
Ann Hepatol. 2019 Nov - Dec;18(6):918-928
pubmed: 31151874
Cardiovasc Diabetol. 2013 Jan 03;12:3
pubmed: 23286208
Diabetologia. 2009 Nov;52(11):2288-98
pubmed: 19655124
Int J Cardiol. 2016 Oct 1;220:595-601
pubmed: 27390996
Circulation. 2018 Oct 9;138(15):1537-1550
pubmed: 29941478
Diabetes Obes Metab. 2015 Nov;17(11):1085-92
pubmed: 26250051
Arch Intern Med. 2012 May 28;172(10):761-9
pubmed: 22636820
Diabetes Obes Metab. 2019 Jan;21(1):3-14
pubmed: 30091169
Eur Heart J. 2016 May 14;37(19):1526-34
pubmed: 26819227