Cardiology Letters 2019, 28(1):33-40

How is the treatment of diabetic patients changed to reduce cardiovascular risk?

Murín J¹, Bulas J¹, Wawruch M²

¹ I. interná klinika LFUK a UNB, Nemocnica Staré Mesto, Bratislava

² Ústav farmakológie a klinickej farmakológie LF UK, Bratislava, Slovenská republika

Diabetes mellitus type 2 is an important and serious risk factor of cardiovascular (CV) disease which is here the main reason of mortality in diabetic patients. In the last three of four years the results have been published of large clinical studies with SGLT2 inhibitors and GLP-1 receptor agonists, which have shown a great CV benefit. SGLT2 inhibitors have favourable metabolic, hemodynamic and renal effects which explain their great CV benefit. GLP-1 agonists favourably influence body weight, blood pressure, serum lipids and renal function, but their CV benefit comes later than that from SGLT2 inhibitors treatment. Large clinical studies (EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58) and their meta-analysis have presented a large reduction of heart failure, of progression of diabetic nephropathy and also of major CV have events and CV mortality. The benefit is greater in diabetic patients with CV disease than in patients only with CV risk factors. There is a need to use these drugs more frequently in routine clinical practice.

Keywords: diabetes mellitus type 2; SGLT2 inhibitors; GLP-1 receptor agonists; cardiovascular morbidity and mortality

Published: January 1, 2019  Show citation