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Title: | Contemporary choice of glucose lowering agents in heart failure patients with type 2 diabetes | Authors: | MARTENS, Pieter Janssens, Joyce Ramaekers, Jobbe DUPONT, Matthias MULLENS, Wilfried |
Issue Date: | 2020 | Publisher: | TAYLOR & FRANCIS LTD | Source: | ACTA CARDIOLOGICA, 75 (3) , p. 211 -217 | Abstract: | Background: The choice of glucose lowering agent in heart failure (HF)-patients can have a strong effect on HF-related adverse events, with some classes increasing and other classes reducing the risk. Little data is available about the choice of glucose lowering agents in HF-patients with type-2-diabetes. Methods: We performed a cross-sectional single centre point analysis of all patients with both a diagnoses of HF and type-2-diabetes followed in a tertiary HF-clinic. Medical records were used to determine the choice of current glucose lowering agent. Data at the time of cross-sectional analysis was used to determine potential eligibility to a sodium-glucose-linked-transporter-2-inhibitor (SGLT2-inhibitor) based on the enrolment criteria of the EMPAREG-OUTCOME-trial. Results: A total of 571 HF-patients with diabetes were assessed on June the first 2017. The majority of patients were either managed with one or two glucose lowering agents (43% respectively 34%), with metformin (N = 391;61%), Insulin (N = 278;49%) and sulfonylurea (N = 259;45%) being the most frequently employed treatments. SGLT2-inhibitor use was low (N = 7;1%). According to trial criteria 184 patients (32%) qualified for an SGLT2-inhibitor. With main reasons for ineligibility being a HbA1C < 7% (N = 324) or a glomerular-filtration-rate <30 ml/min (N = 154; of whom 101 patients overlapped with HbA1C < 7%). However 54% of patients with a HbA1C < 7% were treated with >= 2 glucose lowering agents from a class other than SGLT-2-inhibiton. Conclusion: Despite potential eligibility, SGLT2-inhibition remains an underused glucose lowering agent in this contemporary HF-population. Additional research is necessary on optimising its implementation in clinical practice, which might include switching glucose lowering therapies in patients at HbA1C-target. | Notes: | Martens, P (corresponding author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. pieter.martens2@zol.be |
Other: | Martens, P (corresponding author), Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. pieter.martens2@zol.be | Keywords: | Heart failure;pharmacotherapy;type 2 diabetes;glucose lowering agents | Document URI: | http://hdl.handle.net/1942/31805 | ISSN: | 0001-5385 | e-ISSN: | 1784-973X | DOI: | 10.1080/00015385.2019.1569313 | ISI #: | WOS:000538281800005 | Rights: | 2019 Belgian Society of Cardiology. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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Martens_P_2020.pdf Restricted Access | Published version | 1.2 MB | Adobe PDF | View/Open Request a copy |
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