PMID- 24996388
OWN - NLM
STAT- MEDLINE
DCOM- 20150729
LR  - 20181202
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 23
IP  - 11
DP  - 2014 Nov
TI  - New treatments for type 2 diabetes: cardiovascular protection beyond glucose 
      lowering?
PG  - 997-1008
LID - S1443-9506(14)00503-4 [pii]
LID - 10.1016/j.hlc.2014.05.007 [doi]
AB  - The health burden of type 2 diabetes mellitus (T2DM) is increasing worldwide, 
      with a substantial portion of this burden being due to the development of 
      cardiovascular (CV) disease. Multiple individual randomised clinical trials of 
      intensive versus conventional glucose control, based on the use of traditional 
      oral hypoglycaemic agents, have failed to convincingly show that intensive 
      glucose control significantly reduces CV disease outcomes. In recent times, two 
      new approaches to lowering glucose levels have become available. One targets the 
      "incretin effect" which involves the modulation of peptide hormones that normally 
      regulate glucose levels when nutrients are given orally. The other approach is 
      based on inhibiting the sodium-glucose co-transporter 2 (SGLT-2) in the tubules 
      of the kidney to promote glycosuria. Incretin-based therapies, especially 
      glucagon-like peptide-1 receptor analogues, reduce glucose levels, with a low 
      risk of hypoglycaemia, by increasing insulin secretion, inhibiting glucagon 
      release and increasing satiety. Clinical and experimental studies have also shown 
      favourable effects on CV disease risk factors such as dyslipidaemia, blood 
      pressure, and improvements in endothelial function and cardiac contractility. 
      Similarly, SGLT-2 inhibitors reduce glucose levels with a low risk for 
      hypoglycaemia and have positive effects on multiple CV disease risk factors. 
      Whether the beneficial effects of these new glucose lowering approaches on 
      surrogate markers of CV disease risk translates to an improvement in CV events 
      remains unknown. Several CV outcome trials are currently being performed to show 
      that at a minimum, these novel glucose lowering agents are safe, but also have 
      positive CV benefits.
CI  - Copyright (c) 2014 Australian and New Zealand Society of Cardiac and Thoracic 
      Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). 
      Published by Elsevier B.V. All rights reserved.
FAU - Jayawardene, Dilshani
AU  - Jayawardene D
AD  - Departments of Endocrinology & Diabetes and Medicine, St Vincent's Hospital 
      Melbourne & University of Melbourne, Australia.
FAU - Ward, Glenn M
AU  - Ward GM
AD  - Departments of Endocrinology & Diabetes and Medicine, St Vincent's Hospital 
      Melbourne & University of Melbourne, Australia.
FAU - O'Neal, David N
AU  - O'Neal DN
AD  - Departments of Endocrinology & Diabetes and Medicine, St Vincent's Hospital 
      Melbourne & University of Melbourne, Australia.
FAU - Theverkalam, Geetha
AU  - Theverkalam G
AD  - Departments of Endocrinology & Diabetes and Medicine, St Vincent's Hospital 
      Melbourne & University of Melbourne, Australia.
FAU - MacIsaac, Andrew I
AU  - MacIsaac AI
AD  - Department of Cardiology, St Vincent's Hospital Melbourne & University of 
      Melbourne, Australia.
FAU - MacIsaac, Richard J
AU  - MacIsaac RJ
AD  - Departments of Endocrinology & Diabetes and Medicine, St Vincent's Hospital 
      Melbourne & University of Melbourne, Australia. Electronic address: 
      r.macisaac@unimelb.edu.au.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20140610
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
RN  - 0 (Blood Glucose)
RN  - 0 (Incretins)
RN  - 0 (SLC5A2 protein, human)
RN  - 0 (Sodium-Glucose Transporter 2)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
SB  - IM
MH  - Blood Glucose/metabolism
MH  - Diabetes Complications/blood/urine
MH  - Diabetes Mellitus, Type 1/blood/*drug therapy/urine
MH  - Glucagon-Like Peptide 1/*therapeutic use
MH  - Humans
MH  - Incretins/*therapeutic use
MH  - Kidney Tubules/metabolism
MH  - Sodium-Glucose Transporter 2/metabolism
MH  - *Sodium-Glucose Transporter 2 Inhibitors
OTO - NOTNLM
OT  - Cardiovascular
OT  - DPP-4
OT  - GLP-1
OT  - Glucose
OT  - SGLT-2
OT  - Type 2 diabetes
EDAT- 2014/07/06 06:00
MHDA- 2015/07/30 06:00
CRDT- 2014/07/06 06:00
PHST- 2014/05/13 00:00 [received]
PHST- 2014/05/17 00:00 [accepted]
PHST- 2014/07/06 06:00 [entrez]
PHST- 2014/07/06 06:00 [pubmed]
PHST- 2015/07/30 06:00 [medline]
AID - S1443-9506(14)00503-4 [pii]
AID - 10.1016/j.hlc.2014.05.007 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2014 Nov;23(11):997-1008. doi: 10.1016/j.hlc.2014.05.007. Epub 
      2014 Jun 10.