June 1, 2018Open Access
Potentiation of Insulin Signaling Contributes to Heart Failure in Type 2 Diabetes
Resultado clave
Antihyperglycemic drugs acting through insulin signaling increase heart failure risk, whereas drugs ameliorating hyperinsulinemia without insulin signaling reduce this risk.
PICO estructurado
Do antihyperglycemic drugs that act through insulin signaling increase the risk of heart failure in patients with type 2 diabetes?
P
Población
Patients with type 2 diabetes
I
Intervención
Antihyperglycemic drugs (sulfonylureas, thiazolidinediones, incretins, metformin, and sodium-glucose cotransporter 2 inhibitors)
O
Resultado
Risk or clinical course of heart failure
Antihyperglycemic therapies that avoid potentiating insulin signaling, such as metformin and SGLT2 inhibitors, may be preferable for mitigating heart failure risk in type 2 diabetes.
Resumen
The heightened risk of heart failure in type 2 diabetes cannot be explained by the occurrence of clinically overt myocardial ischemic events or hyperglycemia. Experimentally, insulin exerts detrimental effects on the heart, vasculature, kidneys, and adipose tissue that can lead to heart failure. In both randomized clinical trials and observational studies, antihyperglycemic drugs that act through insulin signaling (i.e., sulfonylureas, thiazolidinediones, and incretins) increase the risk or worsen the clinical course of heart failure, whereas drugs that ameliorate hyperinsulinemia and do not signal through insulin (i.e., metformin and sodium-glucose cotransporter 2 inhibitors) reduce the risk of heart failure.
Cite This Study
Milton Packer (Fri,) conducted a review in Type 2 Diabetes and Heart Failure. Antihyperglycemic drugs was evaluated. Antihyperglycemic drugs acting through insulin signaling increase heart failure risk, whereas drugs ameliorating hyperinsulinemia without insulin signaling reduce this risk.