Should sodium-glucose cotransporter-2 inhibitors be first-line treatment for patients with type 2 diabetes?

Van Walraven highlights the United Kingdom Prospective Diabetes Study (UKPDS). The study showed that attaining intensive glucose control in patients with newly diagnosed type 2 diabetes with metformin, sulfonylureas or insulin significantly decreased microvascular complication risks despite a small...

Full description

Saved in:
Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2020-04, Vol.192 (14), p.E375-E376
Main Author: van Walraven, Carl
Format: Article
Language:English
Subjects:
Acute Kidney Injury
Aged
Antidiabetics
Clinical decision making
Cohort Studies
Decision making
Diabetes
Diabetes Mellitus, Type 2 - drug therapy
Drug therapy
Glucose
Heart failure
Humans
Hypoglycemic Agents - therapeutic use
Kidneys
Mortality
Patients
Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
Systematic review
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Van Walraven highlights the United Kingdom Prospective Diabetes Study (UKPDS). The study showed that attaining intensive glucose control in patients with newly diagnosed type 2 diabetes with metformin, sulfonylureas or insulin significantly decreased microvascular complication risks despite a small difference in glycosylated hemoglobin (HbA1c) of only 0.9% between treatment groups. In addition, the study showed that metformin significantly decreased all-cause mortality in those with obesity. Posttrial analyses of UKPDS found that intensive control by any treatment significantly decreased risks of diabetes-related outcomes, myocardial infarction and all-cause mortality. These results were attained despite identical HbA1c levels between treatment groups during posttrial monitoring. The Action to Control Cardiovascular Risk in Diabetes and Action in Diabetes and Vascular Disease: Preterax Diamicron Modified release Controlled Evaluation randomized controlled trials (both subsequently showed that intensive glucose control significantly decreased microvascular disease in those with long-standing type 2 diabetes. This research highlights the importance of good glucose control in the treatment of type 2 diabetes.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.200426