TY - JOUR
T1 - Anti-Diabetic Therapy, Heart Failure and Oxidative Stress
T2 - An Update
AU - Koniari, Ioanna
AU - Velissaris, Dimitrios
AU - Kounis, Nicholas G.
AU - Koufou, Eleni
AU - Artopoulou, Eleni
AU - de Gregorio, Cesare
AU - Mplani, Virginia
AU - Paraskevas, Themistoklis
AU - Tsigkas, Grigorios
AU - Hung, Ming Yow
AU - Plotas, Panagiotis
AU - Lambadiari, Vaia
AU - Ikonomidis, Ignatios
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2022/8
Y1 - 2022/8
N2 - Diabetes mellitus (DM) and heart failure (HF) are two chronic disorders that affect millions worldwide. Hyperglycemia can induce excessive generation of highly reactive free radicals that promote oxidative stress and further exacerbate diabetes progression and its complications. Vascular dysfunction and damage to cellular proteins, membrane lipids and nucleic acids can stem from overproduction and/or insufficient removal of free radicals. The aim of this article is to review the literature regarding the use of antidiabetic drugs and their role in glycemic control in patients with heart failure and oxidative stress. Metformin exerts a minor benefit to these patients. Thiazolidinediones are not recommended in diabetic patients, as they increase the risk of HF. There is a lack of robust evidence on the use of meglinitides and acarbose. Insulin and dipeptidyl peptidase-4 (DPP-4) inhibitors may have a neutral cardiovascular effect on diabetic patients. The majority of current research focuses on sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. SGLT2 inhibitors induce positive cardiovascular effects in diabetic patients, leading to a reduction in cardiovascular mortality and HF hospitalization. GLP-1 receptor agonists may also be used in HF patients, but in the case of chronic kidney disease, SLGT2 inhibitors should be preferred.
AB - Diabetes mellitus (DM) and heart failure (HF) are two chronic disorders that affect millions worldwide. Hyperglycemia can induce excessive generation of highly reactive free radicals that promote oxidative stress and further exacerbate diabetes progression and its complications. Vascular dysfunction and damage to cellular proteins, membrane lipids and nucleic acids can stem from overproduction and/or insufficient removal of free radicals. The aim of this article is to review the literature regarding the use of antidiabetic drugs and their role in glycemic control in patients with heart failure and oxidative stress. Metformin exerts a minor benefit to these patients. Thiazolidinediones are not recommended in diabetic patients, as they increase the risk of HF. There is a lack of robust evidence on the use of meglinitides and acarbose. Insulin and dipeptidyl peptidase-4 (DPP-4) inhibitors may have a neutral cardiovascular effect on diabetic patients. The majority of current research focuses on sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. SGLT2 inhibitors induce positive cardiovascular effects in diabetic patients, leading to a reduction in cardiovascular mortality and HF hospitalization. GLP-1 receptor agonists may also be used in HF patients, but in the case of chronic kidney disease, SLGT2 inhibitors should be preferred.
KW - diabetes
KW - dipeptidyl peptidase 4 inhibitors
KW - glucagon-likepeptide-1 receptor agonists
KW - heart failure with preserved ejection fraction (HFpEF)
KW - heart failure with reduced ejection fraction (HFrEF)
KW - metformin
KW - oxidative stress
KW - SGLT2 inhibitors
KW - sulfonylureas
KW - thiazolidinediones
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U2 - 10.3390/jcm11164660
DO - 10.3390/jcm11164660
M3 - Review article
AN - SCOPUS:85137332524
SN - 2077-0383
VL - 11
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 16
M1 - 4660
ER -