Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)

The use of modern pharmaceuticals and cardiovascular disease (CVD) treatment methods has increased life expectancy and improved the quality of life of both patients with normal carbohydrate metabolism and diabetes mellitus (DM). This study provides a review of the literature on glycaemic control and...

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Autores principales:	Sergey V. Kakorin, Ruben A. Iskandaryan, Ashot M. Mkrtumyan
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2016
Materias:	type 2 diabetes mellitus chronic heart failure (chf) cardiovascular mortality cardiovascular disease (cvd) acute myocardial infarction hyperglycemia glycated hemoglobin metformin sulfonylurea derivates insulin dpp-4 inhibitors sglt-2 inhibitors Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/81527a880f0446f399dd85522567b619
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spelling	oai:doaj.org-article:81527a880f0446f399dd85522567b6192021-11-14T09:00:20ZGlycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)2072-03512072-037810.14341/DM2003422-27https://doaj.org/article/81527a880f0446f399dd85522567b6192016-07-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/7564https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378The use of modern pharmaceuticals and cardiovascular disease (CVD) treatment methods has increased life expectancy and improved the quality of life of both patients with normal carbohydrate metabolism and diabetes mellitus (DM). This study provides a review of the literature on glycaemic control and choice of glucose-lowering therapy in patients with type 2 DM (T2DM) and CVD. According to the latest recommendations for the prevention of CVD, the target level of glycated haemoglobin (HbA1c) should be less than 7.0% and 7.5%–8.0% in older patients to decrease the risk of hypoglycaemia. The target blood glucose level is 7.7–10 mmol/L. The results of randomized clinical trials (RCTs) revealed that the adverse effects of second-generation sulfonylureas include critical hypoglycaemia episodes and increases in CVD-associated complications and mortality. Metformin reduces the risk of CVD in comparison with second-generation sulfonylurea derivates and insulin. Thiazolidinediones are not currently used for patients with CVD, and the safety of GLP-1 analogues and SGLT-2 inhibitors is still under investigation. When metformin therapy is ineffective, DPP-4 inhibitors should be prescribed and renal function should be monitored. Metformin is contra-indicated in patients with severe chronic heart failure (CHF) and acute myocardial infarction (AMI) because of the risk of lactic acidosis with tissue hypoxia. Thus, insulin is the drug of choice for glycaemic control in CVD patients with chronic kidney disease, severe heart failure or other acute clinical conditions.Sergey V. KakorinRuben A. IskandaryanAshot M. MkrtumyanEndocrinology Research Centrearticletype 2 diabetes mellituschronic heart failure (chf)cardiovascular mortalitycardiovascular disease (cvd)acute myocardial infarctionhyperglycemiaglycated hemoglobinmetforminsulfonylurea derivatesinsulindpp-4 inhibitorssglt-2 inhibitorsNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 19, Iss 3, Pp 221-228 (2016)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	type 2 diabetes mellitus chronic heart failure (chf) cardiovascular mortality cardiovascular disease (cvd) acute myocardial infarction hyperglycemia glycated hemoglobin metformin sulfonylurea derivates insulin dpp-4 inhibitors sglt-2 inhibitors Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	type 2 diabetes mellitus chronic heart failure (chf) cardiovascular mortality cardiovascular disease (cvd) acute myocardial infarction hyperglycemia glycated hemoglobin metformin sulfonylurea derivates insulin dpp-4 inhibitors sglt-2 inhibitors Nutritional diseases. Deficiency diseases RC620-627 Sergey V. Kakorin Ruben A. Iskandaryan Ashot M. Mkrtumyan Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
description	The use of modern pharmaceuticals and cardiovascular disease (CVD) treatment methods has increased life expectancy and improved the quality of life of both patients with normal carbohydrate metabolism and diabetes mellitus (DM). This study provides a review of the literature on glycaemic control and choice of glucose-lowering therapy in patients with type 2 DM (T2DM) and CVD. According to the latest recommendations for the prevention of CVD, the target level of glycated haemoglobin (HbA1c) should be less than 7.0% and 7.5%–8.0% in older patients to decrease the risk of hypoglycaemia. The target blood glucose level is 7.7–10 mmol/L. The results of randomized clinical trials (RCTs) revealed that the adverse effects of second-generation sulfonylureas include critical hypoglycaemia episodes and increases in CVD-associated complications and mortality. Metformin reduces the risk of CVD in comparison with second-generation sulfonylurea derivates and insulin. Thiazolidinediones are not currently used for patients with CVD, and the safety of GLP-1 analogues and SGLT-2 inhibitors is still under investigation. When metformin therapy is ineffective, DPP-4 inhibitors should be prescribed and renal function should be monitored. Metformin is contra-indicated in patients with severe chronic heart failure (CHF) and acute myocardial infarction (AMI) because of the risk of lactic acidosis with tissue hypoxia. Thus, insulin is the drug of choice for glycaemic control in CVD patients with chronic kidney disease, severe heart failure or other acute clinical conditions.
format	article
author	Sergey V. Kakorin Ruben A. Iskandaryan Ashot M. Mkrtumyan
author_facet	Sergey V. Kakorin Ruben A. Iskandaryan Ashot M. Mkrtumyan
author_sort	Sergey V. Kakorin
title	Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
title_short	Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
title_full	Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
title_fullStr	Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
title_full_unstemmed	Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
title_sort	glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)
publisher	Endocrinology Research Centre
publishDate	2016
url	https://doaj.org/article/81527a880f0446f399dd85522567b619
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Glycemia control and glucose-lowering therapy in patients with type 2 diabetes mellitus and cardiovascular disease (review of multicenter randomized trials)

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