Hormonal
Thiazolidinediones (specifically Pioglitazone) significantly reduce cardiovascular events (stroke, MI, mortality) in patients with Type 2 Diabetes and macroangiopathies or recent stroke/TIA, independent of glucose lowering.
If you have Type 2 Diabetes and a history of stroke, heart attack, or significant blood vessel disease, ask your doctor about Pioglitazone. It is one of the few diabetes medications proven to significantly reduce the risk of another stroke or heart attack, even in people who do not have diabetes but have insulin resistance. While it can cause side effects like swelling, these are often manageable, and the cardiovascular protection can be life-saving.
In the first of them [PROactive], it was found that pioglitazone significantly reduced overall mortality, as well as the frequency of non-fatal myocardial infarction and stroke. ... In the IRIS study ... the risk of recurrent stroke or myocardial infarction was reduced by 24% compared with the placebo group.
Why this rating
Based on large, randomized, controlled clinical trials (PROactive, IRIS) with clear, statistically significant endpoints.
Source
Decrease of cardiovascular risk in patients with type 2 diabetes: review of the common strategies and clinical studies
В. В. Салухов et al. · Diabetes Mellitus · 2018
DOI 10.14341/dm9570
More from this paper
- GLP-1 receptor agonists (e.g., Liraglutide) and SGLT2 inhibitors (e.g., Empagliflozin) reduce cardiovascular mortality in Type 2 Diabetes patients, primarily through mechanisms involving insulin sensitivity and weight loss rather than direct glucose lowering.Strong
- Reducing insulin resistance, rather than strictly lowering blood glucose, is the primary mechanism for reducing cardiovascular risk in type 2 diabetes.Good
- Intensive lifestyle modification (diet and exercise) reduces cardiovascular risk in Type 2 Diabetes patients, but long-term maintenance of weight loss is difficult, and significant risk reduction is only seen in those who maintain >10% weight loss.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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