After cardiovascular (CV) safety concerns emerged with rosiglitazone use, the Food and Drug Administration (FDA) now requires outcome studies to be performed for all new diabetes medications. The first CV safety study (ELIXA) for a drug in the glucagon-like peptide 1-receptor agonist (GLP-1 RA) class – lixisenatide - was published in December 2015. Lixisenatide is a once-daily injectable GLP-1 RA approved for use in Europe and awaits FDA approval in the United States.
Basal, prandial, NPH, ultra-long, inhaled, 70/30, 75/25, 50/50, U-100, U-200, U-300, and U-500 insulin … the list of options for patients with diabetes requiring insulin continues to expand. Current guidelines for glycemic management of patients with type 2 diabetes provide specific recommendations for the initiation of insulin therapy, but not insulin intensification. The recently published LanScape study provides a foundation for making evidence-based clinical decisions.
With increased emphasis on disease prevention, gestational diabetes (GDM) is worthy of more attention. The incidence is on the rise not only in the United States (U.S.) but worldwide. Complications of GDM such as preeclampsia, cesarean delivery, neonatal hypoglycemia, macrosomia, and birth trauma negatively impact maternal and fetal health. Is a readily available, non-prescription dietary supplement the answer? Recent investigations have examined the use of myo-inositol for GDM prevention, with positive results.
The Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) study sought to determine the effects of empagliflozin on cardiovascular morbidity and mortality in patients with type 2 diabetes at high risk for CVD. Does the evidence from the EMPA-REG OUTCOME study coupled with the other benefits of SGLT2 inhibitors (reduction in weight and blood pressure, mild adverse effects) make empagliflozin the preferred second-line agent from the treatment of type 2 diabetes?