Atherosclerosis – indicator for treatment of patient with type 2 diabetes mellitus

Česká verzia

Authors: Katarína Rašlová ^1,2
Authors place of work: Metabolické centrum MUDr. Kataríny Rašlovej s. r. o., Bratislava ¹; Koordinačné centrum pre familiárne hyperlipoproteinémie, SZU v Bratislave ²
Published in the journal: AtheroRev 2021; 6(2): 90-94
Category: Reviews

Summary

Knowledge of physiological and pathophysiological processes in the regulation of glucose levels has brought new treatment options and new antidiabetics: glucagon-like peptide 1 receptor agonists (GLP1 RA) and sodium glucose cotransporter 2 (SGLT2i) inhibitors. Recently published prospective randomized studies have demonstrated their significant cardiovascular benefits without the risk of hypoglycemia and with a decrease or neutral effect on weight. The results of these studies were the reason for the publication of the new consensus of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). When choosing antidiabetic treatment, the ADA/EASD places special emphasis on reducing cardiovascular (CV) risk and body weight, low risk of hypoglycemia, but also on reducing the progression of renal complications. The position of metformin as a first-line medication does not change, as there is currently insufficient scientific evidence that metformin should not be the drug of the first choice. However, in patients at very high risk of CHD, combination therapy with SGLT2i or GLP1 RA with metformin should be initiated immediately.

Keywords:

Body weight – glucagon-like peptide 1 receptor agonists – hypoglycemia- macrovascular complications – sodium- glucose cotransporter 2 inhibitors – type 2 diabetes

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