cardiovascular outcome in trial of new antidiabetic drugs

Novel antidiabetic drugs and its effect on cardiovascular disease

1. CARDIOVASCULAR OUTCOME IN TRIAL OF NEW ANTIDIABETIC
DRUGS
PROFESSOR / MOHAMMED AHMED BAMASHMOOS

2. RISK FACTORS OF CVD IN TYPE 2-DIABETIC
●1- Hyperglycemia ; any increase in HbA1C by 1 is associated with increase in CV
mortality and morbidity by 11% - 16%
●2- hypoglycemia ; it leads to
● - increased inflammation as CRP
● - endothelial dysfunction
● - sympatho adrenal response
● - increased adrenaline
3- weight gain and obesity ;
● - hypertension
● - dyslipidemia
● - IR
● - increased plasma volume
● - increased inflammation
● -

3. ●4- insulin resistance lead to ;
● - hypertension
● - atherosclerosis
● - dyslipidemia
● - endothelial dysfunction
● - hyperuricemia
● 5- endothelial dysfunction
●6- inflammation
●7- hyper coagulation

4. PATHOGENESIS

6. LIST OF NOVEL ANTIDIABETIC DRUGS
●1- metformin
●2- SGLT type 2 inhibitor
●3- dipeptidyl peptidase type 4 inhibitor
●4- GLP1 receptor agonist

7. Metformin SGLT type 2 GLP1 DPP
HbA1C reduction 1-1.5 0.2-0.8 0.5-1.4 0.5-0.8
Risk of hypoglycemia Neutral N N N
Weight changes Neutral or gradual
decrease
Decrease by 3kg in the
first year
6.5 at 40 weeks of
treatment

Effect in lipid
increase HDL , decrease total
cholesterol , decrease LDL,
VLDL,
Increase HDL Decrease
Increase HDL , decrease
cholesterol , TG
Effect in IR Improve insulin
sensitivity
Decrease IR by
decreasing
glucotoxicity
Decrease IR Decrease
Effect in BP Decrease secondary to
decrease IR
Decrease BP Decrease BP, HR

Decrease BP, HR
Effect in endothelial
function
Improve Improve vascular
function
Enhance function

Enhance function
Inflammatory effect
Decrease proinflammatory
cytokine
Decrease Decrease Decrease
Effect in coagulopathy
decrease PAI type 1. increase
tissue plasminogen activator ,
decrease platelets aggregation
and adhesion )

12. 3- GLP1 RECEPTOR AGONIST

13. 4- DIPEPTIDYL PEPTIDASE TYPE 4 INHIBITOR

17. /