References
Changing the way type 2 diabetes is managed
Abstract
A number of well organised randomised control trials have demonstrated the benefits of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in reducing major adverse cardiac events. Secondary endpoints for SGLT-2is have also shown improvement in outcomes for those with heart failure with reduced ejection fraction and chronic kidney disease with albuminuria. These therapeutic advantages enable risk stratification and for treatment to be individualised depending on patient baseline characteristics. This article discusses the place of different therapeutic agents in the treatment of type 2 diabetes and describes why we should adopt a holistic approach in managing the cardio-renal risk associated with type 2 diabetes in light of the current best practice evidence.
Diabetes is one of the most significant public health challenges. In the UK, 4.7 million people have diabetes. Type 2 diabetes accounts for 90% of cases and is characterised by the progressive decline in β-cell function and increase in insulin resistance. The prevalence of type 2 diabetes in younger populations is growing. It is estimated that by 2025, the number of people living in the UK with diabetes will reach five million (Diabetes UK, 2019).
The main complications of diabetes are microvascular disease affecting the eyes, nerves and kidneys, and macrovascular disease leading to cardiovascular disease (CVD), cerebrovascular disease and lower extremity artery disease (Fowler, 2008).
Poor glucose control is associated with increased risk of complication. Every week diabetes leads to more than 169 amputations, 680 strokes, 530 heart attacks and almost 2 000 cases of heart failure. More than 500 people with diabetes die prematurely every week. Diabetes can also have significant psychological impact leading to diabetes distress, anxiety and depression (Diabetes UK, 2019).
Register now to continue reading
Thank you for visiting Journal of Prescribing Practice and reading some of our peer-reviewed resources for prescribing professionals. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Limited access to our clinical or professional articles
-
New content and clinical newsletter updates each month