Cardiorenal-Protective Glucose-Lowering Medications Flashcards
Describe the mechanism of action of SGLT2 inhibitors.
SGLT2 inhibitors reduce plasma glucose by enhancing urinary excretion of glucose.
What are the cardiovascular and renal benefits of SGLT2 inhibitors?
SGLT2 inhibitors have been shown to reduce the risk of major adverse cardiovascular events, cardiovascular death, myocardial infarction, hospitalization for heart failure, and improve renal outcomes in individuals with type 2 diabetes.
What are the potential side effects of SGLT2 inhibitors?
The use of SGLT2 inhibitors is associated with an increased risk of mycotic genital infections and diabetic ketoacidosis, although the incidence of these side effects is low.
How can the risk of diabetic ketoacidosis be mitigated with SGLT2 inhibitor use?
Education on signs and symptoms of diabetic ketoacidosis and temporary discontinuation of the medication in clinical situations that predispose to ketoacidosis can help mitigate the risk.
How can the risk of diabetic ketoacidosis be mitigated with SGLT2 inhibitor use?
Education on signs and symptoms of diabetic ketoacidosis and temporary discontinuation of the medication in clinical situations that predispose to ketoacidosis can help mitigate the risk.
What are some safety concerns associated with SGLT2 inhibitors?
Early studies raised concerns about acute kidney injury, dehydration, orthostatic hypotension, amputation, and fractures, but longer-term studies have not shown a significant imbalance in risks.
What are the mechanisms of action of GLP-1 receptor agonists?
GLP-1 receptor agonists augment glucose-dependent insulin secretion and glucagon suppression, decelerate gastric emptying, curb postmeal glycemic increments, and reduce appetite, energy intake, and body weight.
What are the approved uses of GLP-1 receptor agonists?
GLP-1 receptor agonists are approved for improving HbA1c in adults with type 2 diabetes and reducing the risk of major adverse cardiovascular events in adults with type 2 diabetes with established cardiovascular disease or multiple cardiovascular risk factors.
What are the approved uses of GLP-1 receptor agonists?
GLP-1 receptor agonists are approved for improving HbA1c in adults with type 2 diabetes and reducing the risk of major adverse cardiovascular events in adults with type 2 diabetes with established cardiovascular disease or multiple cardiovascular risk factors.
How are GLP-1 receptor agonists administered?
GLP-1 receptor agonists are primarily available as injectable therapies, with one oral GLP-1 receptor agonist now available.
What are the benefits of higher doses of GLP-1 receptor agonists?
Higher doses of GLP-1 receptor agonists have been shown to provide greater reductions in HbA1c and weight compared to lower doses.
What are the common side effects of GLP-1 receptor agonists?
The most common side effects of GLP-1 receptor agonists are gastrointestinal in nature, including nausea, vomiting, and diarrhea.
Describe the recommended approach for initiating GLP-1 receptor agonist therapy.
Gradual up-titration of GLP-1 receptor agonists is recommended to mitigate gastrointestinal side effects.
Describe the recommended approach for initiating GLP-1 receptor agonist therapy.
Gradual up-titration of GLP-1 receptor agonists is recommended to mitigate gastrointestinal side effects.
Describe the recommended approach for initiating GLP-1 receptor agonist therapy.
Gradual up-titration of GLP-1 receptor agonists is recommended to mitigate gastrointestinal side effects.
What is the role of GLP-1 receptor agonists in weight management?
GLP-1 receptor agonists have been approved for chronic weight management in individuals with type 2 diabetes.
What are the benefits of SGLT2 inhibitors in individuals with peripheral arterial disease?
SGLT2 inhibitors have been associated with greater absolute outcome benefits in individuals with type 2 diabetes and peripheral arterial disease, without an increase in the risk of major adverse limb events.
What are the potential risks associated with SGLT2 inhibitor use in individuals with COVID-19?
The DARE-19 trial demonstrated a low risk of diabetic ketoacidosis with structured monitoring of acid-base balance and kidney function during inpatient use of SGLT2 inhibitors in adults admitted with COVID-19 and cardiometabolic risk factors.
How do SGLT2 inhibitors compare to placebo in terms of the risk of diabetic ketoacidosis?
SGLT2 inhibitors have been associated with higher rates of diabetic ketoacidosis compared to placebo, although the absolute risk is still low.
What are the benefits of SGLT2 inhibitors in individuals with chronic kidney disease?
SGLT2 inhibitors have been associated with reduced incidence of kidney-related adverse events and greater full recovery from acute kidney injury in individuals with type 2 diabetes and chronic kidney disease.
What is the glycemic efficacy of SGLT2 inhibitors at lower estimated glomerular filtration rate (eGFR)?
SGLT2 inhibitors have lower glycemic efficacy at lower eGFR.
What are the potential side effects of GLP-1 receptor agonists?
The most common side effects of GLP-1 receptor agonists are gastrointestinal in nature, including nausea, vomiting, and diarrhea.
What are the potential side effects of GLP-1 receptor agonists?
The most common side effects of GLP-1 receptor agonists are gastrointestinal in nature, including nausea, vomiting, and diarrhea.
How can the gastrointestinal side effects of GLP-1 receptor agonists be managed?
Gradual up-titration of GLP-1 receptor agonists and patient education can help manage gastrointestinal side effects.
