Comparative safety and efficacy analysis of GLP-1 receptor agonists and SGLT-2 inhibitors among frail individuals with type 2 diabetes in the era of continuous population ageing

European Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 1, 2024

Language: Английский

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Global research trends on DPP-4 inhibitors and cardiovascular outcomes a comprehensive bibliometric analysis

Annals of Medicine and Surgery, Journal Year: 2025, Volume and Issue: 87(4), P. 2133 - 2148

Published: March 7, 2025

Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral antihyperglycemic agents commonly prescribed for type 2 diabetes (T2DM). Due to the intricate relationship between glucose regulation and cardiovascular diseases (CVDs), DPP-4 have attracted attention their safety efficacy. This bibliometric analysis aims provide insights into global research landscape on outcomes (CVOs). Methods: A was performed, using Web of Science Core Collection. Data were analyzed VOSviewer, CiteSpace, Biblioshiny. Results: The United States led in publication output, followed by Japan China. Harvard University Toronto leading institutions. most influential journals Cardiovascular Diabetology Diabetes Obesity & Metabolism. Darren K. McGuire prolific author Rury R. Holman. occurring keyword heart failure. Cluster revealed key thematic areas field, including “incretin-based therapy,” “dipeptidyl inhibition,” “cardiovascular safety.” Emerging clusters, such as “atrial fibrillation,” gained recent years, highlighting evolving investigation. Conclusion: study underscores importance CVOs inhibitors. high frequency keywords “heart failure,” along with terms like “mortality” “risk,” highlights a strong focus complications literature. Our reflected that studies address these critical aspects health, discussing potential role mitigating adverse outcomes, particularly patients T2DM.

Language: Английский

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Association of obstructive sleep apnea symptoms with all‐cause mortality and cause‐specific mortality in adults with or without diabetes: A cohort study based on the NHANES

Journal of Diabetes, Journal Year: 2024, Volume and Issue: 16(4)

Published: April 1, 2024

Abstract Background The association between obstructive sleep apnea syndrome (OSAS) and mortality has not been extensively researched among individuals with varying diabetic status. This study aimed to compare the relationship of OSAS all‐cause cause‐specific in US or without diabetes based on data from National Health Nutrition Examination Survey (NHANES). Methods included participants NHANES 2005–2008 2015–2018 cycles follow‐up information. (OSAS.MAP10) was estimated questionnaire. Hazard ratios (HRs) 95% confidence interval (CI) for were calculated by Cox regression analysis populations different relationships risk examined using survival curves restricted cubic spline curves. Results A total 13 761 7.68 ± 0.042 years included. In nondiabetic group, OSAS.MAP10 positively associated all‐cause, cardiovascular, cancer mortality. prediabetes, related (HR 1.11 [95% CI: 1.03–1.20]) cardiovascular 1.17 1.03–1.33]). exhibited L‐shaped patients (both nonlinear p values <.01). Further threshold effect revealed that death when exceeded scores. Conclusion differed diabetes. Individualized clinical treatment plans should be developed practice reduce metabolic conditions. image

Language: Английский

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The Use of SGLT-2 Inhibitors and GLP-1RA in Frail Older People with Diabetes: A Personalised Approach Is Required

Metabolites, Journal Year: 2025, Volume and Issue: 15(1), P. 49 - 49

Published: Jan. 14, 2025

Background: Frailty is an increasingly recognised complication of diabetes in older people and should be taken into consideration management plans, including the use new therapies sodium glucose cotransporter-2 (SGLT-2) inhibitors glucagon like peptide-1 receptor agonists (GLP-1RA). The frailty syndrome appears to span across a spectrum, from sarcopenic obese phenotype at one end, characterised by obesity, insulin resistance, prevalent cardiovascular risk factors, anorexic malnourished other significant weight loss, reduced less factors. Therefore, may not suitable for every frail individual with diabetes. Objectives: To review characteristics who benefit SGLT-2 or GLP-1RA. Methods: A narrative studies investigating benefits GLP-1RA Results: current evidence indirect, literature suggests that are effective proportional severity frailty. However, patients described benefited such therapy appeared either overweight obese, have higher prevalence unfavourable metabolism factors as dyslipidaemia, gout, hypertension compared non-frail subjects. They also established disease individuals. In absolute terms, their baseline meant they most therapy. this group fulfil criteria phenotype, which likely due metabolic profile phenotype. There no suggest underrepresented totally excluded these studies, living care homes. This intolerant its associated inducing further dehydration, hypotension. Conclusions: Clinicians consider early normal weight, overweight, avoid those subjects ae underweight, anorexic, malnourished.

Language: Английский

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Cellular senescence: from homeostasis to pathological implications and therapeutic strategies

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 3, 2025

Cellular aging is a multifactorial and intricately regulated physiological process with profound implications. The interaction between cellular senescence cancer complex multifaceted, can both promote inhibit tumor progression through various mechanisms. M6A methylation modification regulates the of cells tissues by modulating senescence-related genes. In this review, we comprehensively discuss characteristics senescence, signaling pathways regulating biomarkers mechanisms anti-senescence drugs. Notably, review also delves into interactions cancer, emphasizing dual role senescent microenvironment in initiation, progression, treatment. Finally, thoroughly explore function mechanism m6A revealing its critical gene expression maintaining homeostasis. conclusion, provides comprehensive perspective on molecular biological significance offers new insights for development strategies.

Language: Английский

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Health Care Spending After Initiating Sacubitril-Valsartan vs Renin-Angiotensin System Blockers for Heart Failure Treatment

JAMA Health Forum, Journal Year: 2025, Volume and Issue: 6(2), P. e245385 - e245385

Published: Feb. 14, 2025

Importance For patients with heart failure reduced ejection fraction (HFrEF), treatment sacubitril-valsartan, an angiotensin receptor−neprilysin inhibitor, has become increasingly preferred over angiotensin-converting enzyme inhibitors (ACE-Is) and II receptor blockers (ARBs). However, sacubitril-valsartan is much more expensive than generic ACE-I/ARBs. It unknown whether the high cost of offset by lower spending on hospitalizations other treatments. Objective To compare total out-of-pocket health care among Medicare beneficiaries initiating vs ACE-I/ARBs for HFrEF. Design, Setting, Participants This was a cohort study using data from fee-for-service claims propensity score matching Data analysis performed November 2022 to December 2023. Exposure Initiation or ACE-I/ARB. Patients were matched based 104 covariates, including demographic characteristics, comorbidities, baseline annual spending, use services. Main Outcomes Measures Mean expenditures during 365 days after Censoring incomplete follow-up addressed Kaplan-Meier probability weighting. Cost differences, ratios, 95% CIs calculated nonparametric bootstrapping method 500 samples drawn replacement. Results Among 13 755 pairs HFrEF (mean [SD] age, 77.5 [7.5] years; 5138 [39%] 80 years older; 9949 females [36%] 17 561 males [64%]), mean per person similar initiators ACE-I/ARB (difference, $701; CI, −$132 $1593). Sacubitril-valsartan had higher prescription drug costs $1911; $1704 $2113), inpatient −$790; −$1468 −$72), outpatient −$330; −$664 −$11), $109; $13 $208). Conclusions Relevance found that treat as those ACE-I/ARBs; spending. associated patient costs, which may exacerbate disparities limit access affordability.

Language: Английский

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Comparative cardiovascular effectiveness of newer glucose-lowering drugs in elderly with type 2 diabetes: a target trial emulation cohort study

EClinicalMedicine, Journal Year: 2025, Volume and Issue: 82, P. 103162 - 103162

Published: March 22, 2025

Language: Английский

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Sodium-glucose cotransporter 2 inhibitor partially improves brain mitochondrial function, but does not mitigate cognitive impairment in rats with myocardial infarction

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, Journal Year: 2025, Volume and Issue: unknown, P. 167809 - 167809

Published: March 1, 2025

Language: Английский

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Cardiovascular abnormalities already occurred in newly-diagnosed patients with early-onset type 2 diabetes

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: March 26, 2025

The prevalence of early-onset type 2 diabetes (EOD) is rapidly increasing. This study intends to screen for early cardiovascular abnormalities in patients newly diagnosed with EOD and evaluate the risk across cluster phenotypes. A total 400 ≤ 40 years old were enrolled from START cohort (the Study diAgnosed eaRly onset diabeTes). Cluster classification was performed using K-means method based on age, BMI, HbA1c, HOMA2-β, HOMA2-IR, GAD antibodies. Echocardiography carotid ultrasound within 3 months diagnosis. Carotid included intimal thickening plaque formation, while echocardiography assessed changes cardiac structure systolic/diastolic function. Cluster-specific partitioned polygenic scores (pPS) used validate our findings a genetic perspective. artery detected 26.3% patients, observed 20.0%. Patients severe insulin resistant (SIRD) had highest incidence abnormality (40.0%). After adjusting relevant factors, fasting C-peptide levels significantly associated 1.247-fold increase abnormalities. Left atrial enlargement more prevalent SIRD (16.7%) mild obesity-related (MOD) (18.5%) classifications. high proportion abnormal left ventricular geometry (36.1%). Increases level HOMA2IR accompanied by further 1.136-, 1.781- 1.687-fold respectively. pPS lipodystrophy higher group showed significant linear correlation ratio anteroposterior diameter body surface area (LAAP/BSA) (R = 0.344, p < 0.001). Heart are common T2DM at time obesity resistance clinical characteristics enables accurate identification increased complications an stage.

Language: Английский

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The Safety and Efficacy of Sodium-Glucose Cotransporter-2 Inhibitors for Patients with Sarcopenia or Frailty: Double Edged Sword?

Journal of Personalized Medicine, Journal Year: 2024, Volume and Issue: 14(2), P. 141 - 141

Published: Jan. 26, 2024

Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) show cardiovascular protective effects, regardless of the patient’s history diabetes mellitus (DM). SGLT2is suppressed adverse events in patients with type 2 DM, and furthermore, SGLT-2is reduced risk worsening heart failure (HF) or death HF. Along these research findings, are recommended for HF latest guidelines. Despite benefits, concern surrounding increasing body weight loss other has not yet been resolved, especially sarcopenia frailty. The DAPA-HF DELIVER trials consistently showed efficacy safety SGLT-2i However, Rockwood frailty index that derived from a cumulative deficit model was employed assessment trials, which might be suitable evaluation physical alone. There is no fixed consensus on tool to use its cutoff value diagnosis patients, can receive safely. In this review, we summarize methodology discuss

Language: Английский

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