Newer oral treatments show risk-reduction benefits for people with type 2 diabetes

Camille Bienvenu
Thu, 30 Mar 2017
Newer oral treatments show risk-reduction benefits for people with type 2 diabetes
A new study has shown that newer oral glucose-lowering drugs (GLDs) have certain advantages for people with type 2 diabetes.

Some GLDs seem to reduce risks of death rates, heart disease, and severe hypoglycemia more so than insulin.

Researchers at the Karolinska Institute, in Sweden, have studied the effects of two GLDs on these outcomes, compared to insulin, in over 20,000 adults with type 2 diabetes during the course of one and a half year.

The participants were split into two groups. In the first group were those who had been newly prescribed a GLD, either in the form of a dipeptidyl peptidase-4 (DPP-4) inhibitor or the sodium-glucose cotransporter-2 (SGLT2) inhibitor, Forxiga (dapagliflozin).

The second group of participants was initiating an insulin treatment. Researchers tested whether the GLDs fared better in lowering risks for all-cause mortality, CVD and severe hypoglycemia, than insulin.

The results showed that it was indeed the case. The GLDs group (DPP-4 plus Forxiga) had a 44 per cent decreased risk for all-cause mortality, 15 per cent less risks of fatal and nonfatal CVD, and a 74 per cent decreased risk for severe hypoglycemia.

When the two GLDs were put head-to-head in a separate analysis, Forxiga appeared to have a little edge over DPP-4 inhibitors.

For example, the risk for CVD was significantly lowered with Forxiga compared to insulin, while the DPP-4 inhibitors bore the same level of risk as insulin in that regard.

Statistically speaking, the use of Forxiga was associated with a 49 per cent decreased risk for fatal and nonfatal CVD, compared with insulin.

Farxiga users also had a 56 per cent lower risk for all-cause mortality. In contrast, the DPP-4 group had a 41 per cent decreased risk for all-cause mortality, compared with insulin.

However, when it comes to reducing risks of severe hypoglycemia, DPP-4 inhibitors appeared superior to Forxiga.

Compared with the insulin group, participants taking a DPP-4 inhibitor had a 69 per cent lower risk for severe hypoglycemia whereas no significant reduction in risk was seen with Forxiga.

Overall, treatments with any of the novel GLDs appear to offer additional risk reduction benefits. But Forxiga was associated with a lower risk of both all-cause mortality and CVD, whereas DPP-4 inhibitors only lowered the risk of all-cause mortality.
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