scholarly journals Sodium-glucose co-transporter-2 inhibitors and the risk of major arrhythmias: a meta-analysis of the cardiovascular and renal outcome trials

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Boulmpou ◽  
D Patoulias ◽  
E Teperikidis ◽  
C E Papadopoulos ◽  
P Sarafidis ◽  
...  

Abstract Background Type 2 diabetes mellitus is closely associated with cardiovascular disease and evidence already exists on its arrhythmogenic action. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a unique class of oral antidiabetic medications which recently attracted attention for reducing the total risk of major adverse cardiovascular events in a series of recent, large placebo-controlled randomized clinical trials (RCTs). Dapagliflozin and empagliflozin additionally seem to improve survival and outcomes in patients with heart failure with reduced ejection fraction (HFrEF), irrespective of the presence of diabetes mellitus. Whether antidiabetic treatment with sodium-glucose co-transporter inhibitors could reduce the arrhythmic burden in diabetic patients still is to be clarified. Purpose The purpose of the present meta-analysis was to report the impact of SGLT2i on the risk for several types of cardiac arrhythmias, pooling data from all relevant cardiovascular and renal outcome, placebo-controlled, RCTs, comparing SGLT2i to placebo. Methods We searched PubMed for all available cardiovascular and renal outcome RCTs utilizing SGLT2i, along with grey literature sources. We sought to determine the risk of the following arrhythmias/cardiac disorders with the use of SGLT2i versus placebo: atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, ventricular extrasystoles, sinus bradycardia, sinus node dysfunction, second degree atrioventricular block, complete atrioventricular block. Results We extracted relevant data from 8 trials (5 dedicated cardiovascular outcome trials, 2 dedicated renal outcome trials, 1 trial enrolling patients with HFrEF), pooling data in a total of 55,966 patients. SGLT-2i treatment compared to placebo produced a significant reduction in the risk of atrial fibrillation equal to 21% (RR=0.79, 95% CI: 0.67–0.93, I2=0%) (Figure 1). A non-significant reduction in the risk of atrial flutter equal to 9% (RR=0.91, 95% CI: 0.64–1.29, I2=0%) was also observed with SGLT2i (Figure 2). No significant effect on the rest major arrhythmias was observed. Conclusions Antidiabetic therapy with SGLT2i seems to hold a significant impact on antiarrhythmic burden in type 2 diabetes mellitus, reducing the risk of atrial fibrillation development. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2




2021 ◽  
Author(s):  
Sujan Banik ◽  
Antara Ghosh

Abstract Purpose: Although the exact etiologies of type 2 diabetes mellitus (T2DM) are not well defined, the effect of oxidative stress is considered an important factor in the development of T2DM. However, there are controversial outcomes in the association between oxidative stress biomarker levels and T2DM. The present study was aimed to critically examine the association of oxidative stress biomarkers with T2DM.Methods: We systematically searched different electronic databases like PubMed, Google Scholar, ScienceDirect, and Web of Science to find relevant articles up to 31 December 2019. The pooled standard mean difference (SMD) with a 95% confidence interval (CI) was used to define the variation between the study groups. Results: A total of 22 case-control studies with 2853 subjects (1667 diabetic patients and 1186 healthy controls) were selected for this meta-analysis. The pooled results of meta-analysis showed a significant difference in the malondialdehyde (MDA) levels [SMD (95% CI): 2.27 (1.62, 2.91)], nitric oxide (NO) levels [SMD (95% CI): 1.40 (0.00, 2.81)], glutathione (GSH) levels [SMD (95% CI): -1.76 (-2.94, -0.59)], and total antioxidant status (TAS) levels [SMD (95% CI): -1.40 (-2.28, -0.51)] between patients group and controls. Whereas, there was no significant difference observed in the superoxide dismutase (SOD) levels [SMD (95% CI): -1.20 (-2.55, 0.15)] and glutathione peroxidase (GPX) levels [SMD (95% CI): 0.07 (-2.80, 2.94)].Conclusion: The current meta-analysis suggests that oxidative stress might have a potential role in the pathogenesis of T2DM in humans. Further studies should be needed to elucidate the possible mechanism and strengthen this evidence.



Author(s):  
Carlos Alexandre Soares Andrade ◽  
João Lucas Carvalho Paz ◽  
Gabriel Simino de Melo ◽  
Nour Mahrouseh ◽  
Alessandro Lourenço Januário ◽  
...  

Abstract Objectives To evaluate the survival rate, success rate, and peri-implant biological changes of immediately loaded dental implants (ILs) placed in type 2 diabetic patients (DM2). Materials and methods The present study was registered on PROSPERO and followed the PRISMA checklist. The search was performed by the first reviewer in January 2021. The electronic databases used were MEDLINE via PubMed, Cochrane, BVS, Web of Science, Scopus, LIVIVO, and gray literature. The risk of bias analysis was performed using an instrument from the Joanna Briggs Institute. Results A total of 3566 titles and abstracts were obtained. The qualitative synthesis included 7 studies, while the quantitative synthesis included 5 studies. The meta-analysis of IL in individuals with DM2 compared to nondiabetic individuals showed no significant difference among the groups regarding the survival rate of dental implants (RR = 1.00, 95% CI 0.96–1.04; p = 0.91; I2 = 0%), even if the patient had poor glycemic control (RR = 1.08, 95% CI 0.87–1.33; p = 0.48; I2 = 70%). Meta-analysis of marginal bone loss in IL compared to conventional loading in DM2 patients also showed no significant difference (mean difference =  − 0.08, 95% CI − 0.25–0.08; p = 0.33; I2 = 83%). Conclusions Type 2 diabetes mellitus does not seem to be a risk factor for immediately loaded implants if the glycemic level is controlled, the oral hygiene is satisfactory, and the technical steps are strictly followed. Clinical relevance Rehabilitation in diabetic individuals is more common due to the highest prevalence of edentulism in this population. It is essential to establish appropriate protocols for loading dental implants.



QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A H A Youssuf ◽  
I H Elabbassy ◽  
M G Elfouly ◽  
M T G Abdelgawad

Abstract Background Among the competition between the various surgical school, each to prove the superiority of its surgical method to treat obesity & metabolic syndromes, here comes our meta-analysis to search through & collect the various trials to avoid bias concerning the effect of single anastomosis duodeno-ileal bypass with sleeve gastrostomy on the rapidly growing type 2 diabetes mellitus population. Objective To assess the effect of single anastomosis duodeno-ileal bypass (SADI) on type 2 diabetes mellitus patients and the magnitude of their metabolic benefit from undergoing surgery, to help both surgeons and patients make their decisions through giving them a realistic and neutral clearer picture of the expected postoperative outcome. Patients and Methods 10 papers included, our total number of assessed diabetic patients in this meta-analysis reached approximately 257 patients (excluding one study which did not specify the number of its diabetic participants). Results Concerning the need for post-operative medication (whether insulin or oral hypoglycemic: In 5 studies there was no more need for medication post-operatively and in the other five the overall remission rate exceeded 90%. Concerning C-peptide results: C-peptide was mentioned as a quantitative post-operative result in only 3 studies. Fortunately it was within normal ranges post-operatively in the 3 studies. However the other studies pointed to it indirectly when mentioning their complete remission rates. Concerning HbA1c: 7 studies revealed the outcome of their patients’ Hba1c postoperatively and it reached the normal in all. In fact; neither fasting nor post-prandial blood sugar data were provided by any of the studies. Conclusion Single anastomosis duodeno-ileal bypass proved to be very convenient and competitive surgical option for the treatment of resistant diabetes mellitus cases associated with mild to severe obesity.



2015 ◽  
Vol 85 (3-4) ◽  
pp. 145-155 ◽  
Author(s):  
Marjan Ghane Basiri ◽  
Gity Sotoudeh ◽  
Mahmood Djalali ◽  
Mohammad Reza Eshraghian ◽  
Neda Noorshahi ◽  
...  

Abstract. Background: The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. Methods: We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. Results: The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors. Conclusion: This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.



Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.



Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1159-P
Author(s):  
GLENN M. DAVIES ◽  
ANN MARIE MCNEILL ◽  
ELIZA KRUGER ◽  
STACEY L. KOWAL ◽  
FLAVIA EJZYKOWICZ ◽  
...  


Author(s):  
Arwa Aljabali ◽  
Roaa Maghrabi ◽  
Ahmad Shok ◽  
Ghufran Alshawmali ◽  
Abdullah Alqahtani ◽  
...  


2019 ◽  
Vol 18 (3) ◽  
pp. 247-255
Author(s):  
Sierra-Puente D. ◽  
Abadi-Alfie S. ◽  
Arakanchi-Altaled K. ◽  
Bogard-Brondo M. ◽  
García-Lascurain M. ◽  
...  

Spices such as cinnamon (Cinnamomum Spp.) have been of interest due to their phytochemical composition that exert hypoglycemic effects with potential for management of type 2 diabetes mellitus (T2DM). We summarize data from 27 manuscripts that include, one book chapter, 3 review articles, 10 randomized controlled trials, 4 systematic reviews with meta-analysis, and 9 preclinical studies. The most frequently used cinnamon variety was Cinnamomum cassia rather than the Cinnamomum zeylanicum, whereas outcomes were defined as fasting blood glucose, glycated hemoglobin, and oral glucose tolerance test. A great variability in methodology such as different doses (from 120 mg to 6 g), duration of intervention, data retrieved and use of different concomitant medication, were found to be key aspects of most of trials and systematic reviews with meta-analysis available to date. Low quality studies have been made in most cases with a lot of heterogeneity clouding significance of results. More research needs to be done in order to yield accurate evidence for evidence-based recommendations. Its use is not currently a reliable nor advisable option for the treatment of T2DM.



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