Type 2 diabetes mellitus in patients with ischemic stroke – A nationwide study DOI Creative Commons
Sidsel Hastrup, Jakob Nebeling Hedegaard, Grethe Andersen

et al.

Diabetic Medicine, Journal Year: 2024, Volume and Issue: 41(8)

Published: April 25, 2024

Abstract Aims Type 2 diabetes (T2D) is a risk factor for ischemic stroke (IS) and associated with an adverse prognosis. Both care has evolved substantially during the last decade. This study aimed to determine prevalence of T2D among IS patients along time trends in profile, use glucose‐lowering medications, quality‐of‐care clinical outcomes, including severity; length‐of‐stay; mortality, readmission recurrent large national cohort. Methods Registry‐based cohort all events Denmark from 2004 2020. co‐morbid were compared without while adjusting age, sex, severity, co‐morbidity socio‐economic factors. Results The included 169,262 events; 24,479 T2D. increased 12.0% (2004–2006) 17.0% (2019–2020). adjusted absolute 30‐day mortality decreased 9.9% 7.8% corresponding ratios (aRR) 1.22 95% confidence interval (1.09–1.37) 1.29 (1.11–1.50), respectively. aRR 365‐day was 2004–2006: 1.20 (1.12–1.29) 2019–2020: 1.34 (1.22–1.47). 30‐ readmissions rates also consistently higher Conclusions over time. time‐period but Readmissions highlights urgent need strategies further improve prognosis

Language: Английский

Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities DOI Creative Commons
Simona Sacco, Matteo Foschi, Raffaele Ornello

et al.

Diabetologia, Journal Year: 2024, Volume and Issue: 67(7), P. 1192 - 1205

Published: April 16, 2024

Abstract Diabetes mellitus is a significant risk factor for both ischaemic and haemorrhagic stroke, affecting up to third of individuals with cerebrovascular diseases. Beyond being diabetes hyperglycaemia have negative impact on outcomes after stroke. Hyperglycaemia during the acute stroke phase associated higher transformation poor functional outcome, evidence in favour early intervention limit manage severe hyperglycaemia. Similarly, intensive glucose control nested broader bundle care, including blood pressure, coagulation temperature control, can provide substantial benefit clinical As micro- macrovascular complications are frequent people diabetes, cardiovascular prevention strategies also need consider tailored treatment. In this regard, availability sodium–glucose cotransporter 2 inhibitors glucagon-like peptide 1 receptor agonists allow treatments, particularly those heart failure chronic kidney disease as comorbidities. Here, we review main concepts hyperacute management CVD among capitalising results from large studies RCTs inform clinicians preferred treatments. Graphical

Language: Английский

Citations

8
GLP-1 Receptor Agonists and SGLT2 Inhibitors in Type 2 Diabetes: Pleiotropic Cardiometabolic Effects and Add-on Value of a Combined Therapy DOI
André Scheen

Drugs, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 28, 2024

Language: Английский

Citations

8
Underuse of GLP-1 receptor agonists in the management of type 2 diabetes despite a favorable benefit-safety profile DOI
André Scheen

Expert Opinion on Drug Safety, Journal Year: 2024, Volume and Issue: 23(7), P. 797 - 810

Published: May 13, 2024

Patients with type 2 diabetes (T2DM) are at high risk of atherosclerotic cardiovascular disease (ASCVD) and death. Cardiovascular protection is a key objective in T2DM.

Language: Английский

Citations

4
The Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Atrial Fibrillation Burden In Diabetic Patients DOI
George G. Kidess, Mohammad Hamza,

Rohit Goru

et al.

The American Journal of Cardiology, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

0
Comparative Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-Like Peptide-1 Receptor Agonists in Reducing Cardiovascular Events in Patients With Type 2 Diabetes DOI Open Access
Hashmat Khan,

Bilal Akhtar,

Bhavna Singla

et al.

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: May 14, 2025

Language: Английский

Citations

0
Effects of GLP‐1 receptor agonists on incidence and outcomes of ischemic stroke and myocardial infarction: A systematic review and meta‐analysis DOI

Nawal Alammari,

AMAL SAAD ALSHEHRI, Aya Khalaf

et al.

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: May 19, 2025

Abstract Introduction Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) demonstrate cardiovascular benefits beyond glycemic control, but the of protection across cerebrovascular and territories remain incompletely studied in literature. We aim to evaluate whether GLP‐1 RAs provide balanced against stroke myocardial infarction (MI) identify factors that modify this protection. Methods conducted a systematic review meta‐analysis randomised controlled trials comparing with placebo reported outcomes. calculated hazard ratios (HRs) for MI developed novel Territorial Benefit Ratio (TBR = HR stroke/HR MI) quantify relative versus coronary Meta‐regression analyses identified modifying territorial Results Eleven 85 373 participants met inclusion criteria. significantly reduced (HR 0.88, 95% CI 0.80–0.96) 0.87, 0.79–0.97), resulting an overall TBR 1.01 (95% 0.89–1.15). Protection patterns varied by patient subgroups: prior history provided better 0.73, NNT 54), while 0.79, 55). emerged earlier within first six months 0.81), strengthened over time (over 24 months: 0.80). Renal dysfunction, atrial fibrillation, hypertension shifted towards stroke, dyslipidemia Conclusions protection‐in‐territory‐at‐risk pattern important temporal findings results translated. These support personalised approach RA therapy considers patients’ vascular risk profiles. The emergence later strengthening deliver significant highlights clinical expectations treatment persistence.

Language: Английский

Citations

0
Paradoxical real-life underuse of GLP-1 receptor agonists in type 2 diabetes patients with atherosclerotic cardiovascular disease DOI Creative Commons
André Scheen

Diabetes Epidemiology and Management, Journal Year: 2024, Volume and Issue: 14, P. 100197 - 100197

Published: Jan. 19, 2024

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce the risk of cardiovascular (CV) complications in patients with type 2 diabetes (T2DM) and atherosclerotic disease (ASCVD) placebo-controlled CV outcome trials, yet use these cardioprotective agents remains rather low clinical practice. Analysis proportion T2DM treated GLP-1RAs retrospective observational studies by comparing versus without established ASCVD. Nine cohorts from seven were collected international literature between 2019 2022. Overall, percentages (< 10 %) most studies, a progressive increase was noticed over time. The ASCVD slightly lower 7 out 9 not higher when compared to (odds ratio 0.80, 95 % CI 0.79–0.81). Despite positive trend last decade, real-world limited, especially Bridging gap evidence effects their underuse practice at high/very high should be considered as key objective for health care providers, cardiologists.

Language: Английский

Citations

3
Cardiovascular protection significantly depends on HbA1c improvement with GLP-1RAs but not with SGLT2 is in type 2 diabetes: A narrative review DOI
André Scheen

Diabetes & Metabolism, Journal Year: 2023, Volume and Issue: 50(2), P. 101508 - 101508

Published: Dec. 28, 2023

Language: Английский

Citations

4
Diabetes and Stroke: Impact of Novel Therapies for the Treatment of Type 2 Diabetes Mellitus DOI Creative Commons
Inês Vieira, Tânia Carvalho, Joana Saraiva

et al.

Biomedicines, Journal Year: 2024, Volume and Issue: 12(5), P. 1102 - 1102

Published: May 16, 2024

Type 2 diabetes mellitus (T2DM) is a significant risk factor for stroke. Nevertheless, the evidence supporting stringent glycemic control to reduce macrovascular complications, particularly stroke, not as clear microvascular complications. Presently, reduction strategies are based on controlling multiple factors, including hypertension, dyslipidemia, glycemia, smoking, and weight. Since 2008, new pharmacological therapies treating T2DM have been required undergo trials ensure their cardiovascular safety. Remarkably, several novel exhibited protective effects against combined endpoint of major events. Evidence from these trials, with stroke secondary endpoint, along real-world data, suggests potential benefits in prevention, glucagon-like peptide 1 receptor agonists. Conversely, data sodium–glucose cotransporter type inhibitors remains more controversial. Dipeptidyl peptidase 4 appear neutral prevention. More recent still lack this particular outcome. This article provides comprehensive review most prevention impact clinical practice.

Language: Английский

Citations

1
Novel Molecules in Diabetes Mellitus, Dyslipidemia and Cardiovascular Disease 2.0 DOI Open Access
Cosmin Mihai Vesa,

Simona Bungău

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(17), P. 9527 - 9527

Published: Sept. 2, 2024

Diabetes mellitus, dyslipidemia and cardiovascular disorders represent very prevalent chronic diseases in developed countries contributing to a high morbidity loss of quality life [...].

Language: Английский

Citations

1