PMID- 31778747
OWN - NLM
STAT- MEDLINE
DCOM- 20200406
LR  - 20200408
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 159
DP  - 2020 Jan
TI  - CVOTs: What did the endocrinologist learn?
PG  - 107947
LID - S0168-8227(19)31659-6 [pii]
LID - 10.1016/j.diabres.2019.107947 [doi]
AB  - The recent CVOTs which tested the new glucose-lowering drugs (GLD) show that in 
      patients with type 2 diabetes mellitus (T2DM) it is now possible to reduce 
      cardiovascular complications including ischemic events and hospitalization for 
      heart failure, and mortality, and, to some extent, microvascular complications of 
      diabetes, in particular renal outcomes. Additionally CVOTs provide major 
      informations on safety and metabolic effects for long-term use of these drugs. 
      The benefits with GLP-1 RAs are most likely derived through the reduction of 
      atherosclerosis-related events while SGLT-2is seem mostly to reduce heart 
      failure-related events. Specific mechanisms independent from glucose control are 
      involved. Based on CVOTs results it is time, as stated in the new EASD-ADA and 
      ESC/EASD guidelines, to take into consideration such opportunities in the 
      decision-making process when treating T2DM patients, favoring the use of drugs 
      that have shown clear cardiovascular and renal benefits. The treatment decisions 
      require more expertise in the evaluation of cardiovascular and renal risk which 
      becomes a major determinant for the choice of GLD treatment, the target for 
      lipids, the adjustment of anti-hypertensive treatments and the prescription of 
      aspirin. In this context it is essential that endocrinologists-diabetologists 
      communicate more with cardiologists and nephrologists and with the primary care 
      practitioners.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Valensi, Paul
AU  - Valensi P
AD  - Department of Endocrinology Diabetology Nutrition, Jean Verdier Hospital, APHP, 
      Paris 13 University, CINFO, CRNH-IdF, Bondy, France. Electronic address: 
      paul.valensi@aphp.fr.
FAU - Prevost, Gaetan
AU  - Prevost G
AD  - Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie Univ, 
      UNIROUEN, Rouen University Hospital, Rouen, France. Electronic address: 
      gaetan.prevost@chu-rouen.fr.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20191126
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Endocrinologists/*standards
MH  - Humans
MH  - Hypoglycemic Agents/pharmacology/*therapeutic use
OTO - NOTNLM
OT  - CVOTs
OT  - Cardiovascular outcomes
OT  - Diabetes
OT  - Heart failure
OT  - Microangiopathic complications
OT  - Randomized clinical trials
COIS- Declaration of Competing Interest Paul Valensi disclosed the potential following 
      conflict of interest: - lectures for Abbott, AstraZeneca, Bayer, Eli-Lilly, 
      Hikma, Merck-Sharp-Dohme, Novo Nordisk, Novartis, Pfizer, Sanofi; - research 
      grants from Abbott, Bristol-Myers-Squibb-AstraZeneca, Novo Nordisk; participation 
      to Expert Committees for Astra Zeneca, Boehringer Ingelheim, Novo Nordisk, 
      Daiichi-Sankyo, Sanofi. Gaetan Prevost disclosed the potential following conflict 
      of interest: - lectures for Abbott, AstraZeneca, Eli-Lilly, Merck-Sharp-Dohme, 
      Novo Nordisk, Sanofi; participation to Expert Committees for Merck-Sharp-Dohme, 
      Novo Nordisk, Sanofi.
EDAT- 2019/11/30 06:00
MHDA- 2020/04/09 06:00
CRDT- 2019/11/29 06:00
PHST- 2019/11/17 00:00 [received]
PHST- 2019/11/19 00:00 [accepted]
PHST- 2019/11/30 06:00 [pubmed]
PHST- 2020/04/09 06:00 [medline]
PHST- 2019/11/29 06:00 [entrez]
AID - S0168-8227(19)31659-6 [pii]
AID - 10.1016/j.diabres.2019.107947 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2020 Jan;159:107947. doi: 10.1016/j.diabres.2019.107947. 
      Epub 2019 Nov 26.