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Cardio Diabetes Medicine 2017 471

Cardio Vascular Safety of Antidiabetic

Drugs Do We Know Enough?

Dr.S.Saravanan, MD (Gen.MED)

Senior Assistant Professor / Registrar, Department of General Medicine
Govt. Thoothukudi Medical College, Thoothukudi.

Abstract : 5. SGLT -2 : Sodium Glucose co-transporter – 2
Type 2 Diabetes Mellitus (Type 2 DM) , cardiovascular 6. CVD : Cardiovascular death
disease (CVD) and the cardiovascular effect of
anti diabetic drugs are today critical medical 7. CVOT : Cardiovascular outcome trials
issues. Better control of Diabetes Mellitus reduces
Microvascular complications, but has limited effect Introduction:
on macrovascular complications including cardio Cardio vascular disease is the leading cause of
vascular mortality.Given the cardiovascular adverse Morbidity and Mortality among patients with diabetes,
events associated with rosiglitazone, both the Food underscoring the importance of choosing anti diabetic
and Drug Admistration and the European Medicines drugs that do not increase cardiovascular risk but
Agency currently require the demonstrations of might reduce the risk of cardiovascular events.
cardiovascular safety of new antidiabetic drugs. Prompted by the adverse effects of rosiglitazone
Consequently, clinical trials to guarantee their in the RECORD study and subsequent meta
cardiovascular safety are now obligatory. This analysis the US FDA since 2008 and European
article aims to summarize the available evidence on medicines agency [EMA)since 2012 require besides
the cardiovascular effects and safety of the major beneficial hypoglycemic action, appropriate clinical
drugs used in type 2 Diabetes Mellitus treatment cardiovascular outcome trials (CVOT) and safety
and also to provide an overview of clinical trials. Our evidence of all anti diabetic drugs.
belief is review will be of substantial assistance to all
medical doctors who are treating Diabetic patients This article examines the current issues and evidence
namely primary care physicians, internal medical related to cardiovascular safety for each class of
doctors, endocrinologists, diabetologists and less oral anti diabetic drugs understanding the potential
well experienced personnel such as young doctors cardiovascular risk associated with these drugs will
in training. help clinicians and patients with treatment decisions
for TYPE 2DM.
Key words : Antidiabetic Drugs, Cardiovascular side
effects and safety, Diabetes Mellitus, Treatment Generally, there is strong clinical trial evidence
outcome. demonstrating that oral anti diabetic drugs reduce
hyperglycemia to a similar degree and significantly
Obbreviations: decrease the risk of micro vascular complications.
However the strategy used to reduce blood glucose
1. UKPDS : United Kingdom Prospective Diabetes may affect a patient’s cardiovascular risk. For
Study
example in the ACCORD study. (Action to control
2. ACCORD :Action to control cardiovascular risk cardiovascular risk in Diabetes) patients with a
in diabetes median 10 yrs history of type 2 Diabetes and mean
HBA1c of 8.3 were treated to rapidly achieve glycemic
3. MACE : Major adverse cardiovascular events
targets of 60% (intervention group) or maintain their
4. DPP - 4 : Dipeptidyl Peptidase 4 current glycemic control. Although the ACCORD study

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