Questions regarding the role of sodium-glucose co-transporter-2 inhibitors (SGLT2i) in heart failure have been raised since the publications of EMPA-REG OUTCOME in 2015. The recent results of the Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure (DAPA-HF) shed some light on the potential for these medications in HFrEF. In this blog, we discuss the implications of DAPA-HF and the role of SGLT2i for heart failure, including perspectives from a cardiologist.
Treatment of diabetes is associated with a reduction in both macro- and microvascular complications. Macrovascular complications include myocardial infarction and stroke. One of the goals of therapy for patients with type 2 diabetes mellitus is a reduction in hemoglobin A1c (HbA1c). The goal or target HgbA1c is individualized for patients based on the presence of comorbidities, among other factors. Cardiovascular disease (CVD), when present, may influence an individual’s HbA1c goal. This blog will review the data surrounding the HbA1c goal in those with type II diabetes and established CVD.
Significant focus has been placed on the cardiovascular effects of various treatment options for type 2 diabetes. One topic of concern is the risk of heart failure (HF) associated with dipeptidyl peptidase-4 (DPP-4) inhibitors. This piece reviews the literature on DDP-4 inhibitor therapy and the risk of HF and HF hospitalization. Suggestions on how to apply the literature to practice are also provided.