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Impact of Glucose-Lowering Medications on Cardiovascular and Metabolic Risk in Type 2 Diabetes

1
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), School of Medicine, University of Palermo, 90121 Palermo, Italy
2
Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
3
Faculty of General Medicine, Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University, 050474 Bucharest, Romania
4
Department of Biomolecular Sciences, Section of Biochemistry and Biotechnology, University Carlo Bo of Urbino, 61029 Urbino, Italy
*
Authors to whom correspondence should be addressed.
The authors contributed equally to this work and share the first authorship.
J. Clin. Med. 2020, 9(4), 912; https://doi.org/10.3390/jcm9040912 (registering DOI)
Received: 17 February 2020 / Revised: 20 March 2020 / Accepted: 24 March 2020 / Published: 26 March 2020
(This article belongs to the Section Endocrinology & Metabolism)
Type 2 Diabetes Mellitus (T2DM) is associated with a high risk of atherosclerotic cardiovascular (CV) disease. Among the well-known pathophysiologic factors, crucial roles are played by endothelial dysfunction (caused by oxidative stress and inflammation hyperglycemia-linked), increased activity of nuclear factor kB, altered macrophage polarization, and reduced synthesis of resident endothelial progenitor cells. As consequence, a potentially rapid progression of the atherosclerotic disease with a higher propensity to unstable plaque is arguable, finally leading to significantly increased cardiovascular mortality. Main managements are focused on both prevention and early diagnosis, by targeted treatment of hyperglycemia and vascular complications. Innovative therapeutic approaches for T2DM seek to customize the antidiabetic treatment to each patient in order to optimize glucose-lowering effects, minimize hypoglycemia and adverse effects, and prevent cardiovascular events. The newer drugs (e.g., Glucagon Like Peptide-1 Receptor Agonists, GLP-1 RAs; Sodium GLucose coTransporter-2 inhibitors, SGLT2is; DiPeptidyl Peptidase-4 inhibitors, and DPP4is) impact body weight, lipid parameters, and blood pressure, as well as endothelial (dys)functions, inflammatory markers, biomarkers of both oxidative stress, and subclinical atherosclerosis. The present review summarizes the results of the main trials focused on the cardiovascular safety of these drugs from the CV standpoint. View Full-Text
Keywords: cardiovascular risk; dipeptidyl peptidase-4 inhibitors; glucagon like peptide-1 receptor agonists; sodium glucose cotransporter-2 inhibitors; type 2 diabetes mellitus cardiovascular risk; dipeptidyl peptidase-4 inhibitors; glucagon like peptide-1 receptor agonists; sodium glucose cotransporter-2 inhibitors; type 2 diabetes mellitus
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MDPI and ACS Style

Patti, A.M.; Rizvi, A.A.; Giglio, R.V.; Stoian, A.P.; Ligi, D.; Mannello, F. Impact of Glucose-Lowering Medications on Cardiovascular and Metabolic Risk in Type 2 Diabetes. J. Clin. Med. 2020, 9, 912.

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