Key result
First-line treatment of diabetes in patients with cardiovascular diseases should be metformin, followed by an SGLT-2 inhibitor or GLP-1 receptor agonist, while glitazones and saxagliptin should be avoided.
Why the study?
Diabetes mellitus is an important comorbidity in heart failure that significantly worsens prognosis, making early diagnosis and guideline-directed treatment essential to improve patient outcomes.
This review highlights the importance of selecting diabetes medications with proven cardiovascular benefit, such as SGLT-2 inhibitors and GLP-1 receptor agonists, for patients with heart failure.
Answers are grounded in this paper and cite their sources.
May guide initial therapy in diabetic CVD patients; leaves open prospective validation of optimal sequencing.
Diabetes mellitus is a very important comorbidity in patients with heart failure, as the common presence of both diseases significantly worsens the prognosis of patients. In order to improve the outcome of these patients, it is essential to diagnose both diseases at an early stage and to treat them in accordance with guidelines. In particular, a differentiated medication plays a crucial role. The therapy of heart failure does not differ in patients with diabetes and patients without diabetes. In the treatment of diabetes mellitus, however, it is very important to choose substances that have a positive effect on the cardiovascular outcome of patients. First-line treatment of diabetes in patients with cardiovascular diseases should be metformin, followed by a SGLT-2 inhibitor or GLP-1 receptor agonist with proven cardiac benefit. A rigorous adjustment of risk factors according to current guidelines reduces cardiovascular mortality and hospitalization rates. Glitazones and saxagliptin are associated with increased hospitalization rates and should be avoided in heart failure.
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Baldia et al. (2019) conducted a review in Diabetes mellitus and heart failure. Metformin, SGLT-2 inhibitors, GLP-1 receptor agonists was evaluated. First-line treatment of diabetes in patients with cardiovascular diseases should be metformin, followed by an SGLT-2 inhibitor or GLP-1 receptor agonist, while glitazones and saxagliptin should be avoided.
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