[New and old glucose lowering drugs; a state-of-the-art review]

Ned Tijdschr Geneeskd. 2020 Oct 15:164:D4778.
[Article in Dutch]

Abstract

High glucose values are associated with vascular risk in observational studies, but glucose lowering does not automatically translate into better outcomes for patients In patients with type 2 diabetes and cardiovascular disease, cardiovascular benefits of GLP-1 receptor agonists and SGLT-2 inhibitors have been demonstrated. However, experience in clinical practice is limited and costs are high. In diabetic patients with heart failure and renal complications, SGLT-2 inhibitors may have additional beneficial effects. Metformin may have vascular benefits, but this has not been demonstrated for sulphonylurea derivatives, insulin and DPP-4 inhibitors In patients with a low cardiovascular risk, beneficial vascular effects of glucose lowering drugs have not convincingly been demonstrated. The outcomes of the recent studies will lead to a more personalized treatment strategy for type 2 diabetes. Treatment choices will depend upon patient's risk of complications, the goal of therapy, patient preferences and costs.

Publication types

  • Review

MeSH terms

  • Blood Glucose / drug effects*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Cardiomyopathies / etiology
  • Diabetic Cardiomyopathies / prevention & control*
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Glucagon-Like Peptide-1 Receptor / agonists
  • Glycemic Control / methods*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use
  • Metformin / therapeutic use
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • Sulfonylurea Compounds / therapeutic use

Substances

  • Blood Glucose
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents
  • Insulin
  • Sodium-Glucose Transporter 2 Inhibitors
  • Sulfonylurea Compounds
  • Metformin