Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies

Military Medical Academy of S.M. Kirov, Saint-Petersburg, Russia Recent clinical trials about the cardiovascular safety of empagliflozin and liraglutide demonstrated a convincing lowering effect on mortality from cardiovascular causes among the patients with type 2 diabetes. These findings resulted...

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Autores principales:	Vladimir V. Salukhov, Yurii Sh. Khalimov, Sergey B. Shustov, Dmitriy V. Kadin
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2018
Materias:	type 2 diabetes diabetic drugs insulin resistance cardiovascular risk cardioprotection cardiovascular outcomes Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/0938f70fe352468e937a00e32e7e3b3e
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spelling	oai:doaj.org-article:0938f70fe352468e937a00e32e7e3b3e2021-11-14T09:00:21ZDecrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies2072-03512072-037810.14341/DM9570https://doaj.org/article/0938f70fe352468e937a00e32e7e3b3e2018-08-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/9570https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Military Medical Academy of S.M. Kirov, Saint-Petersburg, Russia Recent clinical trials about the cardiovascular safety of empagliflozin and liraglutide demonstrated a convincing lowering effect on mortality from cardiovascular causes among the patients with type 2 diabetes. These findings resulted in many questions about why this phenomenon was seen in two drugs with widely different mechanisms of functioning. It is important to note that the glucose-lowering effect was moderate, although a feature seen in both empagliflozin and liraglutide was their ability to increase insulin sensitivity. In many fundamental studies, this feature was associated with a reduction of cardiovascular risks. Insulin resistance, which has always been a pathophysiological base for the development of cardiovascular disease in patients with type 2 diabetes, is a topic for this report. Different methods to manage insulin resistance, including lifestyle changes, drug treatment and metabolic surgery, are discussed. Furthermore, the most common features of glucose-lowering drugs are analysed, including protective effects for cardiovascular outcomes in patients with type 2 diabetes presented in randomised clinical trials. Studies include the United Kingdom Prospective Diabetes Study (UKPDS), PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive), Insulin Resistance Intervention After Stroke (IRIS), Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) and the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME). The current study shows that the potential to reduce the risk of cardiovascular disease is determined not only by effective lowering of glucose but also by the ability to lower insulin resistance, which causes a paradigm shift in the management of type 2 diabetes.Vladimir V. SalukhovYurii Sh. KhalimovSergey B. ShustovDmitriy V. KadinEndocrinology Research Centrearticletype 2 diabetesdiabetic drugsinsulin resistancecardiovascular riskcardioprotectioncardiovascular outcomesNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 21, Iss 3, Pp 193-205 (2018)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	type 2 diabetes diabetic drugs insulin resistance cardiovascular risk cardioprotection cardiovascular outcomes Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	type 2 diabetes diabetic drugs insulin resistance cardiovascular risk cardioprotection cardiovascular outcomes Nutritional diseases. Deficiency diseases RC620-627 Vladimir V. Salukhov Yurii Sh. Khalimov Sergey B. Shustov Dmitriy V. Kadin Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
description	Military Medical Academy of S.M. Kirov, Saint-Petersburg, Russia Recent clinical trials about the cardiovascular safety of empagliflozin and liraglutide demonstrated a convincing lowering effect on mortality from cardiovascular causes among the patients with type 2 diabetes. These findings resulted in many questions about why this phenomenon was seen in two drugs with widely different mechanisms of functioning. It is important to note that the glucose-lowering effect was moderate, although a feature seen in both empagliflozin and liraglutide was their ability to increase insulin sensitivity. In many fundamental studies, this feature was associated with a reduction of cardiovascular risks. Insulin resistance, which has always been a pathophysiological base for the development of cardiovascular disease in patients with type 2 diabetes, is a topic for this report. Different methods to manage insulin resistance, including lifestyle changes, drug treatment and metabolic surgery, are discussed. Furthermore, the most common features of glucose-lowering drugs are analysed, including protective effects for cardiovascular outcomes in patients with type 2 diabetes presented in randomised clinical trials. Studies include the United Kingdom Prospective Diabetes Study (UKPDS), PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive), Insulin Resistance Intervention After Stroke (IRIS), Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) and the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME). The current study shows that the potential to reduce the risk of cardiovascular disease is determined not only by effective lowering of glucose but also by the ability to lower insulin resistance, which causes a paradigm shift in the management of type 2 diabetes.
format	article
author	Vladimir V. Salukhov Yurii Sh. Khalimov Sergey B. Shustov Dmitriy V. Kadin
author_facet	Vladimir V. Salukhov Yurii Sh. Khalimov Sergey B. Shustov Dmitriy V. Kadin
author_sort	Vladimir V. Salukhov
title	Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
title_short	Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
title_full	Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
title_fullStr	Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
title_full_unstemmed	Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
title_sort	decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
publisher	Endocrinology Research Centre
publishDate	2018
url	https://doaj.org/article/0938f70fe352468e937a00e32e7e3b3e
work_keys_str_mv	AT vladimirvsalukhov decreaseofcardiovascularriskinpatientswithtype2diabetesreviewofthecommonstrategiesandclinicalstudies AT yuriishkhalimov decreaseofcardiovascularriskinpatientswithtype2diabetesreviewofthecommonstrategiesandclinicalstudies AT sergeybshustov decreaseofcardiovascularriskinpatientswithtype2diabetesreviewofthecommonstrategiesandclinicalstudies AT dmitriyvkadin decreaseofcardiovascularriskinpatientswithtype2diabetesreviewofthecommonstrategiesandclinicalstudies
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Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies

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