Cardiometabolic Health

Two recent studies, one a randomized controlled clinical trial and the other an observational study, show potential cardiovascular advantages to using metformin over sulfonylureas in the treatment of type 2 diabetes.

Randomized controlled data favor metformin

Boston, MA—Optimal cardiovascular (CV) risk reduction in patients with diabetes must be multifactorial, stated James R. Gavin III, MD, PhD, Clinical Professor of Medicine, Emory University, Atlanta, GA, at the 2012 Cardio­metabolic Health Congress.

A great deal is known about CV disease (CVD) in diabetes, yet its prevention remains a paradox. No matter how well its risks are mitigated, the rates of CVD in the presence of diabetes remain higher than in its absence “in ways that simply make no sense,” Dr Gavin said.

Los Angeles, CA—More than half of all coronary heart disease (CHD) events in American patients with diabetes could be prevented with optimal control of risk factors, suggested Nathan Wong, PhD, MPH, Professor and Director, Heart Disease Prevention Program at the University of California, Irvine, at the 2012 American Heart Association meeting.

Los Angeles, CA—Antihypertensive regimens that include a thiazide diuretic or a beta-blocker increase the risk for incident diabetes, according to an observational study presented at the 2012 American Heart Association meeting.

The risk was nearly doubled when both drug classes were used togeth­er compared with antihypertensive combinations that included neither, reported Rhonda Cooper-DeHoff, PharmD, Associate Professor, Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Gainesville.

Los Angeles, CA—A new meta-analysis suggests that the use of dipeptidyl peptidase (DPP)-4 inhibitors to achieve glucose control in patients with type 2 diabetes may be cardioprotective.

Munich, Germany—The Third Universal Definition of Myocardial Infarction, which was developed by 4 major cardiology societies, was presented at the 2012 Congress of the European Society of Cardiology (ESC), by Kristian Thygesen, MD, Professor, Aarhus University Hospital, Denmark. Dr Thygesen is Cochair of the Global Myocardial Infarction Task Force that developed this document and was involved with developing the previous definitions.

Los Angeles, CA—Several new drugs have recently entered the market as effective alternatives to warfarin for the treatment of patients with nonvalvular atrial fibrillation (NVAF).

Los Angeles, CA—Taking a multivitamin did not reduce myocardial infarction (MI), stroke, or cardiovascular (CV) death in older men in the first large-scale, long-term randomized controlled trial to address this question to date.

Cardiovascular (CV) outcomes were not improved with either omega-3 fatty acids or with insulin glargine in a 6-year study of 12,537 patients with dysglycemia and other CV risk factors. The multinational Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial showed that insulin glargine had no effect on cancer, and that it reduced the progression from dysglycemia to diabetes. Hertzel C.

The prevalence of both type 1 and type 2 diabetes has increased substantially among American youth over the past decade, and, with this rise, the rates of diabetes complications have increased. This topic was discussed in a session on pediatric obesity at the 2012 ADA annual meeting.

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