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RESEARCH PRODUCT
Impact of Glucose-Lowering Medications on Cardiovascular and Metabolic Risk in Type 2 Diabetes
Daniela LigiAli A. RizviAnca Pantea StoianFerdinando MannelloAngelo Maria PattiRosaria Vincenza Gigliosubject
cardiovascular riskcardiovascular risk; dipeptidyl peptidase-4 inhibitors; glucagon like peptide-1 receptor agonists; sodium glucose cotransporter-2 inhibitors; type 2 diabetes mellitustype 2 diabetes mellitusglucagon like peptide-1 receptor agonistslcsh:Medicine030209 endocrinology & metabolismInflammationType 2 diabetesDiseaseReview030204 cardiovascular system & hematologyHypoglycemiaBioinformaticsmedicine.disease_cause03 medical and health sciences0302 clinical medicinemedicineEndothelial dysfunctionAdverse effectbusiness.industrylcsh:RType 2 Diabetes MellitusGeneral Medicinemedicine.diseasesodium glucose cotransporter-2 inhibitorsmedicine.symptombusinessdipeptidyl peptidase-4 inhibitorsOxidative stressdescription
Type 2 Diabetes Mellitus (T2DM) is associated with a high risk of atherosclerotic cardiovascular (CV) disease. Among the well-known pathophysiologic factors, crucial roles are played by endothelial dysfunction (caused by oxidative stress and inflammation hyperglycemia-linked), increased activity of nuclear factor kB, altered macrophage polarization, and reduced synthesis of resident endothelial progenitor cells. As consequence, a potentially rapid progression of the atherosclerotic disease with a higher propensity to unstable plaque is arguable, finally leading to significantly increased cardiovascular mortality. Main managements are focused on both prevention and early diagnosis, by targeted treatment of hyperglycemia and vascular complications. Innovative therapeutic approaches for T2DM seek to customize the antidiabetic treatment to each patient in order to optimize glucose-lowering effects, minimize hypoglycemia and adverse effects, and prevent cardiovascular events. The newer drugs (e.g., Glucagon Like Peptide-1 Receptor Agonists, GLP-1 RAs; Sodium GLucose coTransporter-2 inhibitors, SGLT2is; DiPeptidyl Peptidase-4 inhibitors, and DPP4is) impact body weight, lipid parameters, and blood pressure, as well as endothelial (dys)functions, inflammatory markers, biomarkers of both oxidative stress, and subclinical atherosclerosis. The present review summarizes the results of the main trials focused on the cardiovascular safety of these drugs from the CV standpoint.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 | Journal of Clinical Medicine |