The Reasons for the Low Uptake of New Antidiabetic Drugs with Cardiovascular Effects—A Family Doctor Perspective DOI Open Access
Tomislav Kurevija, Dunja Šojat, Zvonimir Bosnić

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(6), P. 1617 - 1617

Published: March 12, 2024

Chronic diseases, such as type 2 diabetes (T2D), are difficult to manage because they demand continuous therapeutic review and monitoring. Beyond achieving the target HbA1c, new guidelines for therapy of T2D have been introduced with groups antidiabetics, glucagon-like peptide-1 receptor agonists (GLP-1ra) sodium-glucose cotransporter-2 inhibitors (SGLT2-in). Despite guidelines, clinical inertia, which can be caused by physicians, patients or healthcare system, results in not being effectively managed. This opinion paper explores shift treatment, challenging assumptions evidence-based recommendations, particularly family considering patient’s overall situation decision-making. We looked possible reasons inertia poor application management T2D. Guidelines antidiabetic drugs should more precise, providing case studies examples define contexts contraindications. Knowledge communication improve confidence include clear statements on areas decision-making supported evidence. Precision medicine initiatives aim identify subcategories (including frail patients) using clustering techniques from data science applications, focusing CV treatment outcomes. Clear, unconditional recommendations personalized may encourage drug prescription, especially physicians dealing diverse patient settings.

Language: Английский

Treatment of chronic kidney disease in older populations DOI
Seiji Kishi, Hiroyuki Kadoya, Naoki Kashihara

et al.

Nature Reviews Nephrology, Journal Year: 2024, Volume and Issue: 20(9), P. 586 - 602

Published: July 8, 2024

Language: Английский

Citations

17
Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition) DOI Creative Commons
Lixin Guo, Xinhua Xiao

Aging Medicine, Journal Year: 2024, Volume and Issue: 7(1), P. 5 - 51

Published: Feb. 1, 2024

Abstract With the deepening of aging in China, prevalence diabetes older people has increased noticeably, and standardized management is critical for improving clinical outcomes people. In 2021, National Center Gerontology, Chinese Society Geriatrics, Diabetes Professional Committee Aging Well Association organized experts to write first guideline diagnosis treatment Guideline Management Mellitus Elderly China (2021 Edition) . The emphasizes that patients with are a highly heterogeneous group requiring comprehensive assessment stratified individualized strategies. proposes simple treatments de‐intensified strategies diabetes. This edition provides clinicians practical operable guidance, thus greatly contributing full‐cycle promoting extensive development basic research on related fields. past 3 years, evidence‐based medicine fields further advanced, new concepts, drugs, technologies have been developed. editorial committee promptly updated compiled (2024 More precise paths proposed, achieving continued standardization their outcomes.

Language: Английский

Citations

9
Utilization Trends of Glucose-Lowering Medications Among Adult Kidney Transplant Recipients with Type 2 Diabetes in the United States DOI Open Access
Panupong Hansrivijit, Helen Tesfaye, Deborah J. Wexler

et al.

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 651 - 651

Published: Jan. 20, 2025

Background: To date, there are limited studies describing the use of glucose-lowering medications (GLMs) in adult kidney transplant recipients (KTRs), and uptake sodium glucose cotransporter-2 inhibitors (SGLT2is) glucagon-like peptide-1 receptor agonists (GLP1RAs). Thus, we aimed to evaluate GLMs, including SGLT2i GLP1RA, among KTRs with type 2 diabetes (T2D). Methods: This is an ecologic study KTR T2D. Data were sourced from two large U.S. health insurance claim databases 2014 2023. The proportions any user incident GLMs reported percentage. Any GLM was defined through prescription claims, further as absence prior dispensing within preceding 365 days. Results: From 2023, identified 33,913 T2D who prescribed GLMs. GLP1RA increased throughout period (0.4% 14.4% for SGLT2i, 2.8% 12.5% GLP1RA). While insulin most frequently used GLM, ranging 58% 74%, usage gradually declined over time. By initiated nearly (5.1% 5.7% insulin). Compared initiators, initiators (n = 1009) had a higher prevalence cardiovascular comorbidities proteinuria, while 2149) obesity. Conclusions: both time high by Our findings emphasize need effectiveness safety analysis

Language: Английский

Citations

1
Management of older adults with diabetes mellitus: Perspective from geriatric medicine DOI Creative Commons
Hiroyuki Umegaki

Journal of Diabetes Investigation, Journal Year: 2024, Volume and Issue: 15(10), P. 1347 - 1354

Published: Aug. 8, 2024

ABSTRACT Advances in diabetes medication and population aging are lengthening the lifespans of people with mellitus (DM). Older patients often have multimorbidity tend to polypharmacy. In addition, is associated frailty, functional decline, cognitive impairment, geriatric syndrome. Although numbers dementia, disability, and/or increasing worldwide, accumulated evidence on safe effective treatment these populations remains insufficient. patients, especially those older than 75 years old, underrepresented randomized controlled trials various effects, resulting limited clinical for this population. Therefore, a deeper understanding characteristics essential tailor management strategies their needs. The guidelines several academic societies begun recognize importance relaxing glycemic control targets prevent severe hypoglycemia maintain quality life. However, levels thus far based expert consensus rather robust evidence. There an urgent need personalized adults that considers function strives high life through medical treatment. accompanied by require special considerations liaison both carers social resources.

Language: Английский

Citations

6
SGLT2 inhibitors and GLP-1 receptor agonists: which is the best anti-frailty drug? DOI Creative Commons
Pasquale Mone, Michele Ciccarelli, Stanislovas S. Jankauskas

et al.

The Lancet Healthy Longevity, Journal Year: 2024, Volume and Issue: unknown, P. 100632 - 100632

Published: Sept. 1, 2024

Language: Английский

Citations

6
Individualizing Care for Older Adults With Diabetes Amid the Revolution in Pharmacotherapy DOI
Elbert S. Huang

JAMA Internal Medicine, Journal Year: 2024, Volume and Issue: 184(4), P. 435 - 435

Published: Feb. 26, 2024

This JAMA Network Insights reassesses the approach to caring for older adults with diabetes in context of newly available pharmacologic agents.

Language: Английский

Citations

5
Comparative Effectiveness of Second-Line Antihyperglycemic Agents for Cardiovascular Outcomes DOI
Rohan Khera, Arya Aminorroaya, Lovedeep S Dhingra

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(10), P. 904 - 917

Published: Aug. 26, 2024

Language: Английский

Citations

5
Effects of SGLT2 inhibitors on the onset of esophageal varices and extrahepatic cancer in type 2 diabetic patients with suspected MASLD: a nationwide database study in Japan DOI Creative Commons
Takumi Kawaguchi,

Yoshiyuki Fujishima,

Daisuke Wakasugi

et al.

Journal of Gastroenterology, Journal Year: 2024, Volume and Issue: 59(12), P. 1120 - 1132

Published: Oct. 11, 2024

Abstract Background & aim SGLT2 inhibitors (SGLT2i) improve hepatic steatosis in patients with type 2 diabetes mellitus (T2DM) and MASLD. We aimed to investigate the impact of SGLT2i on incidence liver-related events extrahepatic cancer compared DPP4 (DPP4i) T2DM suspected MASLD using a medical claims database Japan. Methods conducted retrospective study Japanese database. Among who were prescribed or DPP4i ( n = 1,628,656), classified into 4204) groups. Effects following outcomes DPP4i: (1) changes HbA1c ALT levels after 6 months, (2) fibrosis index, (3) events/extrahepatic over 12 months. Results After significantly decreased SGLT2i. In contrast, DPP4i. FIB-4 index Although no significant difference was observed overall between two groups, reduced esophageal varices (HR 0.12, 95%CI 0.01–0.95, P 0.044). Moreover, suppressed 0.50, 0.30–0.84, 0.009) Conclusion more beneficial than improving inflammation indices. may suppress life-threatening

Language: Английский

Citations

5
Long-term effects of different hypoglycemic drugs on carotid intima-media thickness progression: a systematic review and network meta-analysis DOI Creative Commons

Qianyu Lv,

Yingtian Yang,

Yanfei Lv

et al.

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 15

Published: May 31, 2024

Objective The progression of carotid intima-media thickness (cIMT) can partially predict the occurrence future cardiovascular events. This network meta-analysis compared effects 14 antidiabetic drugs (acarbose, alogliptin, exenatide, glibenclamide, glimepiride, ipragliflozin, metformin, nateglinide, pioglitazone, rosiglitazone, sitagliptin, tofoglifozin, troglitazone, voglibose) on cIMT. Method PubMed, EMBASE, Cochrane Library, and Web Science were searched to screen all clinical trials treatment cIMT with hypoglycemic agents before March 1, 2024. differences in changes between group control evaluated. Result After screening 8395 citations, 25 studies (6675 patients) included. results indicated that exenatide had best efficacy slowing down progress, [MD=-0.13,95%CI (-0.25, -0.01)], alogliptin [MD=-0.08,95%CI (-0.13, -0.02)] metformin [MD=-0.05, 95%CI (-0.09, are more effective than placebo. Conclusion Long-term may be other Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42024519474.

Language: Английский

Citations

4
Unleashing frailty from laboratory into real world: A critical step toward frailty‐guided clinical care of older adults DOI
Dae Hyun Kim

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: 72(11), P. 3299 - 3314

Published: Aug. 21, 2024

Understanding patients' degree of frailty is crucial for tailoring clinical care older adults based on their physiologic reserve and health needs ("frailty-guided care"). Two prerequisites frailty-guided are: (1) access to information at the point (2) evidence inform decisions information. Recent advancements include web-based assessment tools electronic records integration time-efficient, standardized assessments in practice. Additionally, database scores from administrative claims data enable scalable evaluation effectiveness safety medical interventions across different levels using real-world data. Given limited trials, studies can complement trial results help treatment individuals with frailty. This article, Thomas Catherine Yoshikawa Award lecture I gave American Geriatrics Society Annual Meeting Long Beach, California, May 5, 2023, outlines our group's contributions: developing integrating a index calculator (Senior Health Calculator) into an academic center; claims-based Medicare claims; (3) applying this evaluate effect patients without frailty; (4) efforts disseminate through launch eFrailty website forthcoming addition Centers Medicaid Services Chronic Conditions Data Warehouse. article concludes future directions care.

Language: Английский

Citations

4