PMID- 24448252
OWN - NLM
STAT- MEDLINE
DCOM- 20140418
LR  - 20220223
IS  - 1530-6550 (Print)
IS  - 1530-6550 (Linking)
VI  - 14
IP  - 2-4
DP  - 2013
TI  - Divergent effects of various diabetes drugs on cardiovascular prognosis.
PG  - e107-22
LID - 10.3909/ricm0671 [doi]
AB  - This review discusses the current data on various antidiabetic medications and 
      their effects on major adverse cardiovascular events (MACE). Diabetes mellitus is 
      a potent independent risk factor for MACE, and this risk increases in proportion 
      to the elevation of hemoglobin A1c. Available data suggest that tight glycemic 
      control in patients with diabetes reduces microvascular complications, but has 
      limited effect or may even increase the risk of MACE and other macrovascular 
      complications. For individuals with type 2 diabetes mellitus (T2DM) drugs that 
      reduce postprandial glucose (alpha-glucosidase inhibitors, incretin mimetics, 
      quick-acting bromocriptine, dipeptidyl peptidase-4 inhibitors, and colesevelam) 
      are associated with a decrease in MACE. Drugs that directly reduce insulin 
      resistance (pioglitazone and metformin) are also associated with lesser but still 
      significant decreases in MACE. Insulin, rosiglitazone (but not pioglitazone), and 
      sulfonylureas (especially with glyburide and particularly the glyburide + 
      metformin combination) are associated with increases in MACE. In summary, drugs 
      that reduce postprandial glucose and improve insulin resistance without 
      predisposing patients to hypoglycemia appear to both control hyperglycemia and 
      improve cardiovascular prognosis. However, many of the traditional agents used 
      for treating T2DM, such as insulin and sulfonylureas, do not improve 
      cardiovascular prognosis despite improving hyperglycemia.
FAU - Bell, David S H
AU  - Bell DS
AD  - Southside Endocrinology, University of Alabama at Birmingham, Birmingham, AL.
FAU - Patil, Harshal R
AU  - Patil HR
AD  - Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, 
      Kansas City, MO.
FAU - O'Keefe, James H
AU  - O'Keefe JH
AD  - Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, 
      Kansas City, MO.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Singapore
TA  - Rev Cardiovasc Med
JT  - Reviews in cardiovascular medicine
JID - 100960007
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Biomarkers/blood
MH  - Blood Glucose/drug effects/metabolism
MH  - Cardiovascular Diseases/blood/diagnosis/etiology/mortality/*prevention & control
MH  - Diabetes Complications/blood/diagnosis/etiology/mortality/*prevention & control
MH  - Diabetes Mellitus, Type 2/blood/complications/diagnosis/*drug therapy/mortality
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/adverse effects/*therapeutic use
MH  - Insulin/blood
MH  - Insulin Resistance
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2014/01/23 06:00
MHDA- 2014/04/20 06:00
CRDT- 2014/01/23 06:00
PHST- 2014/01/23 06:00 [entrez]
PHST- 2014/01/23 06:00 [pubmed]
PHST- 2014/04/20 06:00 [medline]
AID - 10.3909/ricm0671 [doi]
PST - ppublish
SO  - Rev Cardiovasc Med. 2013;14(2-4):e107-22. doi: 10.3909/ricm0671.