Diabetic Drug Metformin Reduces Risk Of Heart Disease

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. 

The study

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. 

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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.

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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.

Type 2 Diabetes And Metformin

Definition

Risk factors 

Many risk factors exist for the development of type 2 diabetes and they may include the following issues:

• Age - the risk of developing this condition increases with age, especially after 45 years. This is probably due to people tending to exercise less and losing more muscle mass at this stage of their lives.
• Race - the reason in unknown, but certain races such as African, Asians and Hispanics tend to be more likely to develop type 2 diabetes.
• Having a family history of diabetes in first-degree relatives. 
• Being overweight - the more fatty tissue that is present in the body, the higher the chances are of the cells becoming resistant to effects of insulin.
• Distribution of fatty tissue - fat which is deposited in the abdomen carries a higher risk of developing type 2 diabetes than if it's stored in other parts of the body.
• Physical inactivity - a sedentary lifestyle leads to weight gain which increases the chances of developing this condition.

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Complications  

Type 2 diabetes can cause major issues in the body. It can negatively affect many major and vital organs but controlling glucose levels can reduce the chances of complications and prolong one's life. These complications can include the following:

Cardiovascular disease

• Coronary artery disease which can result in experiencing a heart attack.
• Atherosclerosis (narrowing of the arteries) which can reduce blood flow to the brain and result in a stroke, or to the limbs and result in amputations. It can also result in high blood pressure which can result in cardiac failure.

Neuropathy/nerve damage

• Excess amounts of glucose in the blood can cause damage to the walls of tiny arteries (called capillaries). This then compromises blood flow to the nerves, especially the limbs. The symptoms start off as tingling sensations, burning or numbness in the tips of the fingers and/or toes and can result in losing sense of all feeling in these areas.
• Damage to the nervous system of the digestive tract can result in nausea, vomiting, constipation or diarrhoea. 
• Erectile dysfunction can also occur.

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Nephropathy/kidney damage

• Damage can occur to the filtering system of the kidneys which can lead to kidney failure.
• Irreversible end-stage kidney disease can also occur which needs dialysis or a kidney transplant.

Eye pathology

• Diabetes can cause damage to the vessels supplying blood to the retina and can therefore result in blindness.
• There's an increased risk of developing other issues such as glaucoma or cataracts.

Hearing issues

• Decreased hearing is more common in people with diabetes.

Foot damage

• Diabetes causes decreased blood flow and nerve damage to the extremities, therefore the risk of foot complications rise. 
• Wounds can be sustained and not noticed due to decreased feeling in the feet. If these wounds are left untreated, they can become serious infections which heal poorly due to decreased blood flow.

Skin conditions

• Diabetes causes the immune system to weaken and the skin becomes more susceptible to contracting bacterial or fungal infections.