At the heart of new antidiabetic agents lies hope for delaying the onset of CVD

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Pathology Update

At the heart of new antidiabetic agents lies hope for delaying the onset of CVD

22 May 2019

Wednesday 22 May 2019, 07:00 AM

More change is ahead in diabetes treatment, including improving cardiovascular outcomes for more patients, says Australian expert Jonathan Shaw

The fifth and final article in a series from Pathology Update 2019, this year’s conference of the Royal College of Pathologists of Australasia. Virginia McMillan attended as a guest of the college

Glycaemic targets may be relaxed. If a drug will reduce cardiovascular and renal risk, “what is the point of pushing HbA1c from above 7.5 per cent to

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References

1. Huo L, Magliano DJ, Rancière F, et al. Impact of age at diagnosis and duration of type 2 diabetes on mortality in Australia 1997-2011. Diabetologia 2018 May;61(5):1055–1063. doi: 10.1007/s00125-018-4544-z

2. Tricco AC, Antony J, Khan PA, et al. Safety and effectiveness of dipeptidyl peptidase-4 inhibitors versus intermediate-acting insulin or placebo for patients with type 2 diabetes failing two oral antihyperglycaemic agents: a systematic review and network meta-analysis. BMJ Open. 2014;4(12):e005752. Online 23 December 2014. doi:10.1136/bmjopen-2014-005752

3. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes N Engl J Med 2015; 373:2117–2128. doi: 10.1056/NEJMoa1504720

4. Jakher H, Chang T, Tan M, et al. Canagliflozin review – safety and efficacy profile in patients with T2DM. Diabetes Metab Syndr Obes. 2019;12:209–215. doi: 10.2147/DMSO.S184437

5. Wiviott SD, Raz I, Bonaca MP et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019; 380:347-357. DOI: 10.1056/NEJMoa1812389

6. Marso SP, Daniels GH, Brown-Frandsen K et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016;375(4):311-22. doi: 10.1056/NEJMoa1603827

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How to Treat

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For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews

Wednesday 28 May 2025, 12:50 AM