New findings from a large clinical trial show that newer oral drugs for treating type 2 diabetes produce fewer negative effects on heart health and offer better control of symptoms than insulin after a year.
Researchers from the Karolinska Institutet, in Stockholm, have analysed data from over 20,000 Swedish participants with type 2 diabetes over the course of one year.
The study compared two classes of oral glucose-lowering drugs (GLDs), dipeptidyle-peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter-2 (SGLT-2) inhibitors, with insulin treatment.
The effect of these drugs on all-cause mortality, cardiovascular disease (CVD) and severe hypoglycemia was measured against insulin.
In addition to that, researchers looked at differences for each of these outcomes between DPP-4 inhibitors and dapagliflozi, the SGLT-2 drug used in the study.
According to the findings, the GLDs group had a 44 per cent lower risk of all-cause mortality compared to the insulin group.
The GLDs also cut by 15 per cent the incidence of CVD and were linked to 74 per cent less risks of hypoglycemia among participants.
When looking at dapagliflozin (Forxiga) versus DPP-4 inhibitors, researchers found that dapagliflozin use resulted in 56 per cent and 49 per cent less risks of all-cause mortality and CVD, respectively.
Unlike dapagliflozi, the DPP-4 inhibitors were only associated with a lower risk of all-cause mortality.
These results tend to indicate that GLDs, such as DPP-4 inhibitors and SGLT-2 inhibitors are superior to insulin for reducing CVD, hypoglycemia and fatal risks.
Among the GLDs, dapagliflozin appears safer as it is associated with lower risks of both all-cause mortality and CVD.
While the study suggests that GLDs may produce fewer side effects than insulin in relation to CVD and hypoglycemia risks, they do produce some side effects.
There is, for example, evidence that DPP-4 inhibitors can cause chronic disabling joint pain, and that certain SGLT-2 inhibitors, including dapagliflozi, may increase the risk of diabetic ketoacidosis (DKA).

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