Heart Disease and Diabetes Management
The Role of Antidiabetic Medications
Heart disease is a significant co-morbidity that complicates diabetes management. Recent research has focused on comparing the cardiovascular safety profiles of canagliflozin with three other classes of antidiabetic drugs. Sodium glucose co-transporter 2 (SGLT2) inhibitors, a new class of antidiabetic medications, have demonstrated cardiovascular benefits in patients with type 2 diabetes. These medications function by inhibiting the re-absorption of glucose in the kidneys, which leads to lower blood glucose levels. Notable examples of this drug class include canagliflozin, dapagliflozin, and empagliflozin.
Risks of Intensive Glucose Lowering
While it is crucial to maintain blood glucose levels within a target range to mitigate the risk of complications, intensive glucose reduction and the use of some antidiabetic medications have been linked to adverse outcomes for heart health.
Recent Study on Canagliflozin
Study Overview
A recent study published in The British Medical Journal assessed the cardiovascular safety outcomes associated with canagliflozin compared to DPP-4 inhibitors, GLP-1 agonists, and sulfonylureas. This population-based retrospective cohort study analyzed data from a healthcare database in the United States, covering the period from April 2013 to September 2015. The study included adults diagnosed with type 2 diabetes who began treatment with canagliflozin, a DPP-4 inhibitor, GLP-1 agonist, or a sulfonylurea during the 30-month study interval.
Main Outcomes Evaluated
The primary outcomes measured were hospital admissions for heart failure and other heart health indicators, including admissions for acute myocardial infarction, ischemic stroke, or hemorrhagic stroke.
Findings on Heart Failure Risk
Canagliflozin’s Impact
The results indicated that participants taking canagliflozin experienced a 30% to 49% reduction in the risk of developing heart failure. Additionally, these individuals had fewer hospital admissions for heart failure compared to those on other antidiabetic medications. Notably, there were no significant differences in the risk of hospital admissions for acute myocardial infarction, ischemic stroke, or hemorrhagic stroke across the four drug classes.
Conclusions
This study highlights the positive effects of canagliflozin on reducing hospital admissions related to heart failure. Furthermore, the benefits of this medication may become evident within the first six months of treatment. The findings underscore the significance of SGLT2 inhibitors in enhancing cardiovascular outcomes for patients with diabetes.
Author Information
Written by Anuolu Bank-Oni, PharmD, CDE, BCGP.
Reference
Patorno, E et al. Cardiovascular outcomes associated with canagliflozin versus other non-gliflozin antidiabetic drugs: population-based cohort study. BMJ 2018;360:k119.