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Diabetes can lead to fatal complications if not properly controlled. The most common issues tends to be involved with cardiovascular conditions which include heart attacks and strokes. Other complications of diabetes can also include kidney failure, blindness and amputation of limbs.
An analysis of 204 studies was recently published where the researchers looked at which diabetic medications aided in lowering the risk of developing cardiovascular complications due to diabetes, and whether one type of medication was better than another in this function.
Many new diabetic drugs have been introduced in the market over the last few years, therefore it was important to conduct this review since it would provide an update on previous studies that were done comparing diabetic drugs.
The participants in the studies were from all over the world and they were generally overweight people who had uncontrolled glucose levels. The elderly and people with significant health issues were excluded from the studies.
Factors that were examined in these studies included not only cardiovascular disease, but also other medication effects such as glucose control and side-effects such as weight gain, gastrointestinal problems and lowered glucose levels. The researchers also reported on how the diabetic drugs worked on their own, as monotherapy, and in combination. Injectable insulin was only compared if it was used as combination therapy with other oral drugs.
The findings of the review were as follows:
- The DPP-4 inhibitors, which were introduced around 2011, were found to be less effective in lowering blood glucose levels as compared to the older drugs metformin and the sulphonylureas.
- A very new class of diabetic medications known as the SGLT-2 inhibitors, which cause glucose to be removed from the blood via the kidneys, were found to increase the incidence of yeast infections in 10% of patients using this drug.
- SGLT-2 inhibitors and the GLP-1 receptor agonists helped patients to lose weight, whereas the sulphonylureas caused weight gain and were the biggest culprits in causing lowered glucose levels in patients.
The significance of this review
The above-mentioned findings have shown that metformin should still be used as first-line therapy in the treatment of diabetes. This helps public health agencies to continue with their current management protocols. It will also lower the financial burden on these agencies and the patients since metformin is still a relatively inexpensive medication.