Dr Angela Murphy explains further.
Cardiovascular disease includes heart attack, angina, heart failure, stroke, and blockage of the arteries in the legs (peripheral arterial disease). In addition, patients with Type 2 diabetes are 10 times more likely to develop end stage kidney disease compared to people without diabetes. New diabetic guidelines suggest that classes of medications that can decrease these complications, as well as lower blood glucose levels, should be used early in diabetes management.
The two classes of medications are:
- The Glucagon-like peptide 1 (GLP-1) receptor agonists – these drugs have three major benefits:
- Glucose lowering by stimulating the pancreas to increase insulin and decrease glucose production in the liver
- Weight loss by directly inhibiting the appetite centre in the brain and decreasing the emptying of the stomach so a person feels full for longer
- Heart protection by direct effects on heart muscle and blood vessels. This is specific to daily liraglutide injection or weekly dulaglutide injection.
- The sodium glucose like transporter 2 (SGLT-2) inhibitors – these drugs act in the kidney to decrease the reabsorption of glucose. More glucose gets excreted in the urine, thereby lowering blood glucose. Sodium is lost with the glucose, and this has a beneficial effect on both kidney and heart function. Dapagliflozin and empagliflozin are available as daily tablets.
Chat to your doctor or diabetes nurse to see if you would benefit from these new therapies.