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Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes

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Good morning my name is alison carrera i’m going to talk about typoglycin and cardiovascular outcomes in type 2 diabetes definition what is about my flossing apoglo closing is a medication belonging to the glyphosate family that is used for the treatment of diabetes mellitus it was approved by the fda on january 8 2014 with an indication of control of hyperglycemia

In type 2 diabetic patients only one sglt2 inhibitors work now sglt2 inhibitors are used in type 2 diabetes to help to reduce the blood sugar levels they differ slightly from most anti-diabetic drugs which work by either increasing the insulin in the body or increasing the insulin sensitivity of the cells of the body and the objective of increasing the insulin

Or the insulin sensitivity is to get the body to take more glucose out of the blood and to store it in the tissues and that’s how they reduce blood sugar levels however in sgl t2 inhibitors they work slightly differently they work by causing the kidneys to excrete glucose into the urine and by excreting glucose into the urine you reduce the amount of glucose

Or sugar that’s in the blood and the rest of the body applications in medicine the primary efficacy outcomes were mace and a composite of cardiovascular death or hospitalization for heart failure secondary efficacy outcomes were a renal composite 40 percent decrease in estimated glomerular flirtation rate to less than 60 millimeters per minute per 1.73 square

Meters of body surface area new end stage renal disease are dead from renal or cardiovascular causes and dead from any cause study of patients enrolled over the past two decades several studies have highlighted the importance of intensive glucose lowering therapy blood pressure control and statin use to reduce the risk of cardiovascular complications and mortality

In patients with diabetes but the long-term trends of mortality and cardiovascular outcomes of patients with type 1 or type 2 diabetes as compared with the general population are unknown pros and cons diabetes we have newer anti-diabetic medicines i’m not going to cover them all but let’s first look at uh trials related to sgl t2 inhibitors maybe chris you can

Just kind of tell us what that class is and talk about some of the outcomes trials you’re not going to go into all the details but give us a broad feel this has been such an exciting time uh and the first of these trials was the emperor reg trial with hemp glows and an sglt2 inhibitor inhibits this exchanger so that glucose goes out in the urine but changes

Probably pressure in the glomeruli in the kidney you get weight loss lots of other beneficial factors with the entire class and so out of surprise there was a significant reduction in cardiovascular events and indeed prevasta mortality so this caught everyone’s attention it really has ushered in a new era in our thinking about how to manage cardiovascular risk

For patients with diabetes pros the study suggests that using both typography and insulin has an advantage doctors measure values to see how well blood sugar levels are regulated over the longer term this measurement shows the average blood sugar levels over the last few months cons the study showed that the pacliflosing has a disadvantage in terms of these side

Effects genital infections occurred in 15 of 800 patients who receive both about myflosing and insulin compared to only four of 800 patients who receive insulin alone issue applied in ecuador recently the inhibitors of sodium glucose called transporter type 2 sglt2 used for the treatment of diabetes mellitus type 2 have demonstrated a cardiorenal protector effect

Experimental essays and different studies have established that the inhibitors of sglt2 reduce the progression of a hypertrophic cardiomyopathy fibrosis cardiac remodeling systolic dysfunction and heart failure little ways so one is so my overall impression was that this trial like other sglt2 inhibited trials again proved that there is substantial benefit in

Terms of reduction of heart failure hospitalization risk as you know there was a split uh primary endpoint of this trial the maze endpoint did not reach statistical significance but the combined endpoint of cardiovascular death and heart failure hospitalization did reach the end point which was positive conclusion in patients with type 2 diabetes who had or

Were raised for atherosclerotic cardiovascular disease treatment without buying difficulty did not result in a higher or lower rate of mace than placebo but they result in a lower rate of cardiovascular death or hospitalization for heart failure a finding that reflects a lower rate of hospitalization for heart failure one nice thing about farsiga are at a higher

Risk for utis compared to also been reports of ketoa now we’ll move on to side effects and these mostly tie in with precautions that we just discussed so urinary tract infection is one of the most common side effects you can experience because of the reasons we talked about and this is much more pronounced than women women are at a higher risk for utis compared

To men in general so this can happen in up to six percent of patients and i would guess that this percentage would be much higher if we were talking just about females also those that are 75 years old and older are at an increased risk of getting this side effect as well genital infections are also possible and this is primarily in women nasopharyngitis is also

Listed as a possible side effect with around seven percent of people getting this and this is basically having symptoms that mirror a common cold stuffing nose and inflammation of the nasal cavities and when i see this listed as a side effect for medication it makes me wonder if the drug is really causing this so in the clinical trials if you get mesopharyngitis

It is reported as a side effect now the question i have is is it really the drug causing this or are these people just getting a common cold i’m not really sure to be honest but it is listed as a side effect for farsiga you can also see an increase in urine output and nausea in a small percentage of people thank you

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Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes By Allison Cabrera