cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2020-1-2378cardiovascular-2378Research ArticleОБЗОРЫREVIEWSПроблемы выбора сахароснижающей фармакотерапии у больных сахарным диабетом и острым нарушением мозгового кровообращенияGlucose-lowering medication selection in patients with diabetes and acute cerebrovascular accidenthttps://orcid.org/0000-0003-1830-3600ЗанозинаО. В.ZanozinaO. V.

Занозина Ольга Владимировна — доктор медицинских наук, профессор кафедры госпитальной терапии им. В. Г. Вогралика, заведующий эндокринологическим отделением НОКБ им. Н. А. Семашко, SPIN-5626-3137.

 

Нижний Новгород. Тел.: +7 (960) 172-77-85

Nizhny Novgorod

zwx2@mail.ruhttps://orcid.org/0000-0001-8430-237XСорокинаЮ АSorokinaYu. A.

Кандидат биолонических наук., доцент кафедры общей и клинической фармакологии, SPIN РИНЦ 3909-2456, Scopus Author ID 56392793300.

Нижний Новгород

 

Nizhny Novgorod

zwx@inbox.ruhttps://orcid.org/0000-0003-1480-183XЛовцоваЛ ВLovtsovaL. V.

Доктор медицинских наук, заведующий кафедры общей и клинической фармакологии.

Нижний Новгород

Nizhny Novgorod

lovcovalubov@mail.ruФГБОУ ВО “Приволжский исследовательский медицинский университет” Минздрава России; ГБУЗ НО Нижегородская областная клиническая больница им. Н. А. СемашкоPrivolzhsky Research Medical University; N.A. Semashko Nizhny Novgorod Regional Clinical HospitalФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииPrivolzhsky Research Medical UniversityФГБОУ ВО “Приволжский исследовательский медицинский университет” Минздрава РоссииPrivolzhsky Research Medical University2020030320201919498Copyright © Занозина О.В., Сорокина Ю.А., Ловцова Л.В., 20202020Занозина О.В., Сорокина Ю.А., Ловцова Л.В.Zanozina O.V., Sorokina Y.A., Lovtsova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2378

Обзор посвящен анализу существующих подходов к ведению больных сахарным диабетом при остром нарушении мозгового кровообращения. На основании результатов мета-анализов клинических исследований определены целевые показатели гликемии в первые сут. острого нарушения мозгового кровообращения, изложена тактика ведения пациентов в первые сут. заболевания с позиций сторонников и противников инсулинотерапии, приведены плюсы и минусы различных способов введения инсулина, определены перспективы дальнейшего ведения пациентов с использованием сахароснижающих препаратов у пациентов с сахарным диабетом 2 типа.

The review presents the analysis of current approaches to the management of diabetic patients with acute cerebrovascular accident. Based on the results of meta-analyzes, glycemic targets on the first day after acute cerebrovascular accident were determined and management strategy regarding the insulin therapy issue was discussed. The pros and cons of various ways injecting insulin and the prospects for further management of patients with the use of glucose-lowering medications in patients with type 2 diabetes were considered.

сахарный диабетострое нарушение мозгового кровообращенияцелевой уровень гликемииинсулинотерапияперсонализированная пероральная сахароснижающая терапияdiabetesacute cerebrovascular accidentglycemic targetinsulin therapypersonalized oral glucose-lowering therapyReferencesАлгоритмы специализированной медицинской помощи больным сахарным диабетом. Под редакцией И. И. Дедова, М. В. Шестаковой, А. Ю. Майорова. 9-й выпуск. М.:УП ПРИНТ; 2019. 212с. ISBN: 978-5-91487-136-6. doi:10.14341/DM221S1.Algorithms of specialized medical care for patients with diabetes mellitus. Edited by II Dedov, MV Shestakova, AYu Majorov. 9th issue. M.: UP PRINT; 2017. 212 p. (In Russ.) ISBN: 978-5-91487-136-6. doi:10.14341/DM221S1.Бондарь И. А., Краснопевцева И. П. Особенности течения острого нарушения мозгового кровообращения при сахарном диабете 2 типа. Медицина и образование в Сибири. 2015;(3):45.Bondar IA, Krasnopevtseva IP. Features of the course of acute cerebrovascular accident in type 2 diabetes mellitus. Journal of Siberian Medical Sciences. 2015;(3):45. (In Russ.)Maahs DM, Daniels SR, de Ferranti SD, et al. Cardiovascular disease risk factors in youth with diabetes mellitus: a scientific statement from the American Heart Association. Circulation. 2014;130:1532-58. doi:10.1161/CIR.0000000000000094.Maahs DM, Daniels SR, de Ferranti SD, et al. Cardiovascular disease risk factors in youth with diabetes mellitus: a scientific statement from the American Heart Association. Circulation. 2014;130:1532-58. doi:10.1161/CIR.0000000000000094.Танашян M. M., Антонова К. В., Лагода О. В. и др. Острые нарушения мозгового кровообращения и сахарный диабет 2 типа. Анналы клинической и экспериментальной неврологии. 2014;8(3):4-8.Tanashyan MM, Antonov KV, Lagoda OV, et al. Acute stroke and type 2 diabetes. Annals of Clinical and Experimental Neurology. 2014;8(3):4-8. (In Russ.) Танашян M. M., Антонова К. В., Лагода О. В. и др. Острые нарушения мозгового кровообращения и сахарный диабет 2 типа. Анналы клинической и экспериментальной неврологии. 2014;8(3):4-8.Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci. 2016;351(4):380-6. doi:101016/j.amjms.2016.01.011.Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci. 2016;351(4):380-6. doi:101016/j.amjms.2016.01.011.Bellolio MF, Gilmore RM, Ganti L. Insulin for glycaemic control in acute ischaemic stroke. Cochrane Database Syst Rev. 2014;23(1):CD005346. doi:10.1002/14651858.CD005346.pub4.Bellolio MF, Gilmore RM, Ganti L. Insulin for glycaemic control in acute ischaemic stroke. Cochrane Database Syst Rev. 2014;23(1):CD005346. doi:10.1002/14651858.CD005346.pub4.Yatabe T, Inoue S, Sakaguchi M. The optimal target for acute glycemic control in critically ill patients: a network meta-analysis. Intensive Care Med. 2017;43:16-28. doi:10.1007/s00134-016-4558-2.Yatabe T, Inoue S, Sakaguchi M. The optimal target for acute glycemic control in critically ill patients: a network meta-analysis. Intensive Care Med. 2017;43:16-28. doi:10.1007/s00134-016-4558-2.Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015;46(10):3020-35. doi:10.1161/STR.0000000000000074.Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015;46(10):3020-35. doi:10.1161/STR.0000000000000074.Стронгин Л. Г., Григорян И. Г., Густов А. В. и др. Инсулинотерапия сахарного диабета 2-го типа в остром периоде инсульта: значение метода введения инсулина. Проблемы эндокринологии. 2014;60(5):4-8. doi:10.14341/probl20146054-8.Strongin LG, Grigoryan IG, Gustov AV, et al. Insulin therapy of type 2 diabetes in the acute period of stroke: the value of the method of insulin administration. Problems of endocrinology. 2014;60(5):4-8. (In Russ.) doi:10.14341/probl20146054-8.Hemphill JC, Greenberg SM, Anderson CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46:2032-60. doi:10.1161/STR.0000000000000069.Hemphill JC, Greenberg SM, Anderson CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46:2032-60. doi:10.1161/STR.0000000000000069.Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133:e38-360. doi:10.1161/CIR.0000000000000350.Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133:e38-360. doi:10.1161/CIR.0000000000000350.Zhu S, McClure LA, Lau H, et al. A. Recurrent vascular events in lacunar stroke patients with metabolic syndrome and/or diabetes. Neurology. 2015;85:935-94. doi:10.1212/WNL.0000000000001933.Zhu S, McClure LA, Lau H, et al. A. Recurrent vascular events in lacunar stroke patients with metabolic syndrome and/or diabetes. Neurology. 2015;85:935-94. doi:10.1212/WNL.0000000000001933.Bellolio MF, Gilmore RM, Stead LG. Insulin for glycaemic control in acute ischaemic stroke. Cochrane Database Syst Rev. 2011;7(9):CD005346. doi:101002/14651858.CD005346.pub3.Bellolio MF, Gilmore RM, Stead LG. Insulin for glycaemic control in acute ischaemic stroke. Cochrane Database Syst Rev. 2011;7(9):CD005346. doi:101002/14651858.CD005346.pub3.Shah AD, Langenberg C, Rapsomaniki E, et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 19 million people. Lancet Diabetes Endocrinol. 2015;3:105-13. doi:10.1016/S2213-8587(14)70219-0.Shah AD, Langenberg C, Rapsomaniki E, et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 19 million people. Lancet Diabetes Endocrinol. 2015;3:105-13. doi:10.1016/S2213-8587(14)70219-0.Bangen KJ, Gu Y, Gross AL, et al. Relationship Between Type 2 Diabetes Mellitus and Cognitive Change in a Multiethnic Elderly Cohort. J Am Geriatr Soc. 2015;63:1075-83. doi:10.1111/jgs.13441.Bangen KJ, Gu Y, Gross AL, et al. Relationship Between Type 2 Diabetes Mellitus and Cognitive Change in a Multiethnic Elderly Cohort. J Am Geriatr Soc. 2015;63:1075-83. doi:10.1111/jgs.13441.The Stroke Hyperglycemia Insulin Network Effort (SHINE) trial protocol: a randomized, blinded, efficacy trial of standard vs. intensive hyperglycemia management in acute stroke. Int J Stroke. 2014;9:246-51. doi:10.1111/ijs.12045.The Stroke Hyperglycemia Insulin Network Effort (SHINE) trial protocol: a randomized, blinded, efficacy trial of standard vs. intensive hyperglycemia management in acute stroke. Int J Stroke. 2014;9:246-51. doi:10.1111/ijs.12045.Ntaios G, Papavasileiou V, Bargiota A, et al. Intravenous insulin treatment in acute stroke: a systematic review and meta-analysis of randomized controlled trials. Int J Stroke. 2014;9:489-93. doi:10.1111/ijs.12225.Ntaios G, Papavasileiou V, Bargiota A, et al. Intravenous insulin treatment in acute stroke: a systematic review and meta-analysis of randomized controlled trials. Int J Stroke. 2014;9:489-93. doi:10.1111/ijs.12225.Drury P, Levi C, D'Este C. Quality in Acute Stroke Care (QASC): process evaluation of an intervention to improve the management of fever, hyperglycemia, and swallowing dysfunction following acute stroke. Int J Stroke. 2014;9:766-76. doi:10.1111/ijs.12202.Drury P, Levi C, D'Este C. Quality in Acute Stroke Care (QASC): process evaluation of an intervention to improve the management of fever, hyperglycemia, and swallowing dysfunction following acute stroke. Int J Stroke. 2014;9:766-76. doi:10.1111/ijs.12202.Koga M, Yamagami H, Okuda S. Blood glucose levels during the initial 72h and 3-month functional outcomes in acute intracerebral hemorrhage: The SAMURAI-ICH study. J Neurol Sci. 2014;350:75-8. doi:10.1016/j.jns.2015.02.018.Koga M, Yamagami H, Okuda S. Blood glucose levels during the initial 72h and 3-month functional outcomes in acute intracerebral hemorrhage: The SAMURAI-ICH study. J Neurol Sci. 2014;350:75-8. doi:10.1016/j.jns.2015.02.018.Clinical guidelines. http://cr.rosminzdrav.ru/#!/schema/146#doc_terms (12 dec 2018). (In Russ.) Клинические рекомендации. Электронный ресурс http://cr.rosminzdrav.ru/#!/schema/146#doc_terms (12.12.2018).Clinical guidelines. http://cr.rosminzdrav.ru/#!/schema/146#doc_terms (12 dec 2018). (In Russ.) http://cr.rosminzdrav.ru/#!/schema/146#doc_terms (12.12.2018).Европейские рекомендации по профилактике сердечно-сосудистых заболеваний в клинической практике (пересмотр 2016). Российский кардиологический журнал. 2017;6(146) :7-32.85. doi:10.15829/1560-4071-2017-6-7-85.European guidelines on cardiovascular disease prevention in clinical practice. 31. Russian Journal of Cardiology. 2017;6(146):7-85. (In Russ.) doi:10.15829/1560-4071-2017-6-7-85.Тюренков И. Н., Куркин Д. В., Бакулин Д. А. и др. Сравнительная церебропротективная активность метформина, госоглиптина, цитиколина и нового агониста GPR119 при экспериментальной ишемии головного мозга на фоне сахарного диабета. Журнал неврологии и психиатрии им. С. С. Корсакова. 2017; Спецвыпуск. 117(12):53-9. doi:10.17116/ jnevro201711712253-59.35.Tyurenkov IN, Kurkin DV, Bakulin DA, et al. Cerebroprotective activity of metformin, gosogliptin, citicoline and a novel GPR119 agonist in cerebral ischemia under experimental diabetes mellitus. Zhurnal nevrologii i psikhiatrii im. S. S. Korsakova. 33. 2017; Special issues. 117( 12):53-9. (In Russ.) doi:10.17116/ jnevro201711712253-59.35.Castilla-Guerra L, Fernandez-Moreno MDC, Leon-Jimenez, et al. Antidiabetic drugs and stroke risk. Current evidence. Eur J Intern Med. 2018;48:1-5. doi: 10.1016/j.ejim.2017.09.019.Castilla-Guerra L, Fernandez-Moreno MDC, Leon-Jimenez, et al. Antidiabetic drugs and stroke risk. Current evidence. Eur J Intern Med. 2018;48:1-5. doi: 10.1016/j.ejim.2017.09.019.Moriea PI. Metformin in the diabetic brain friend or foe? AnnTransl Med. 2014;2(6):54. doi:10.3978/j.issn.2305-5839.2014.06.10.Moriea PI. Metformin in the diabetic brain friend or foe? AnnTransl Med. 2014;2(6):54. doi:10.3978/j.issn.2305-5839.2014.06.10.Fox CS, Golden SH, Anderson C, et al. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Circulation. 2015;132:691-718. doi:10.2337/dci15-0012.Fox CS, Golden SH, Anderson C, et al. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Circulation. 2015;132:691-718. doi:10.2337/dci15-0012.Yaghi S, Furie KL, Viscoli CM, et al. Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke: A Planned Secondary Analysis of the IRIS Trial (Insulin Resistance Intervention After Stroke). Circulation. 2018;137(5):455-63. doi:10.1161/CIRCULATIONAHA.117.030458.Yaghi S, Furie KL, Viscoli CM, et al. Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke: A Planned Secondary Analysis of the IRIS Trial (Insulin Resistance Intervention After Stroke). Circulation. 2018;137(5):455-63. doi:10.1161/CIRCULATIONAHA.117.030458.Spence JD, Viscoli CM, Inzucchi SE, et al. Pioglitazone Therapy in Patients With Stroke and Prediabetes: A Post Hoc Analysis of the IRIS Randomized Clinical Trial. JAMA Neurol. 2019;76(5):526-35. doi:10.1001/jamaneurol.2019.0079.Spence JD, Viscoli CM, Inzucchi SE, et al. Pioglitazone Therapy in Patients With Stroke and Prediabetes: A Post Hoc Analysis of the IRIS Randomized Clinical Trial. JAMA Neurol. 2019;76(5):526-35. doi:10.1001/jamaneurol.2019.0079.Liao HW, Saver JL, Wu YL, et al. Pioglitazone and cardiovascular outcomes in patientswith insulin resistance, pre-diabetes and type 2 diabetes: a systematic review and 40. meta-analysis. BMJ Open. 2017;7(1):e013927 doi:10.1136/bmjopen-2016-013927.Liao HW, Saver JL, Wu YL, et al. Pioglitazone and cardiovascular outcomes in patientswith insulin resistance, pre-diabetes and type 2 diabetes: a systematic review and 40. meta-analysis. BMJ Open. 2017;7(1):e013927 doi:10.1136/bmjopen-2016-013927.DeFronzo RA, Inzucchi S, Abdul-Ghani M, et al. Pioglitazone: The forgotten, 41. cost-effective cardioprotective drug for type 2 diabetes. Diab Vasc Dis Res. 2019;16(2):133-43. doi:101177/1479164118825376.DeFronzo RA, Inzucchi S, Abdul-Ghani M, et al. Pioglitazone: The forgotten, 41. cost-effective cardioprotective drug for type 2 diabetes. Diab Vasc Dis Res. 2019;16(2):133-43. doi:101177/1479164118825376.Tziomalos K, Bouziana SD, Spanou M, et al. Prior treatment with dipeptidyl peptidase 4 inhibitors is associated with better functional outcome and lower in-hospital mortality in patients with type 2 diabetes mellitus 42. admitted with acute ischaemic stroke. Diab Vasc Dis Res. 2015;12(6):463-6. doi:10.1177/1479164115597867.Tziomalos K, Bouziana SD, Spanou M, et al. Prior treatment with dipeptidyl peptidase 4 inhibitors is associated with better functional outcome and lower in-hospital mortality in patients with type 2 diabetes mellitus 42. admitted with acute ischaemic stroke. Diab Vasc Dis Res. 2015;12(6):463-6. doi:10.1177/1479164115597867.Chiazza F, Tammen H, Pintana H, et al. The effect of DPP-4 inhibition to improve functional outcome after stroke is mediated by the SDF-1a/CXCR4 pathway. Cardiovasc Diabetol. 2018;17(1):60. doi:10.1186/s12933-018-0702-3.Chiazza F, Tammen H, Pintana H, et al. The effect of DPP-4 inhibition to improve functional outcome after stroke is mediated by the SDF-1a/CXCR4 pathway. Cardiovasc Diabetol. 2018;17(1):60. doi:10.1186/s12933-018-0702-3.Hardigan T, Yasir A, Abdelsaid M, et al. Linagliptin treatment improves cerebrovascular function and remodeling and restores reduced cerebral perfusion in Type 2 diabetes. Am J Physiol Regul Integr Comp Physiol. 2016;311(3):R466-77 doi: 10.1152/ajpregu.00057.2016.Hardigan T, Yasir A, Abdelsaid M, et al. Linagliptin treatment improves cerebrovascular function and remodeling and restores reduced cerebral perfusion in Type 2 diabetes. Am J Physiol Regul Integr Comp Physiol. 2016;311(3):R466-77 doi: 10.1152/ajpregu.00057.2016.Liang CY, Chen DY, Mao CT, et al. Cardiovascular risk of sitagliptin in ischemic stroke patients with type 2 diabetes and chronic kidney disease: A nationwide cohort study. Medicine (Baltimore). 2018;97(52):e13844. doi:10.1097/MD.0000000000013844. Green JB, Bethel MA, Armstrong PW, et al. Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2015;373:232-42. doi:10.1056/NEJMoa1501352.Liang CY, Chen DY, Mao CT, et al. Cardiovascular risk of sitagliptin in ischemic stroke patients with type 2 diabetes and chronic kidney disease: A nationwide cohort study. Medicine (Baltimore). 2018;97(52):e13844. doi:10.1097/MD.0000000000013844. Green JB, Bethel MA, Armstrong PW, et al. Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2015;373:232-42. doi:10.1056/NEJMoa1501352.Barkas F, Elisaf M, Tsimihodimos V, et al. Dipeptidyl peptidase-4 inhibitors and protection against stroke: A systematic review and meta-analysis. Diabetes Metab. 2017;43(1):1-8. doi:10.1016/j.diabet.2016.10.006.Barkas F, Elisaf M, Tsimihodimos V, et al. Dipeptidyl peptidase-4 inhibitors and protection against stroke: A systematic review and meta-analysis. Diabetes Metab. 2017;43(1):1-8. doi:10.1016/j.diabet.2016.10.006.Sinha B, Ghosal S, Statescu C, et al. Meta-analyses of the effects of DPP-4 inhibitors, SGLT2 inhibitors and GLP1 receptor analogues on cardiovascular death, myocardial infarction, stroke and hospitalization for heart failure. Diabetes Res Clin Pract. 2019;150:8-16. doi:10.1016/j.diabres.2019.02.014.Sinha B, Ghosal S, Statescu C, et al. Meta-analyses of the effects of DPP-4 inhibitors, SGLT2 inhibitors and GLP1 receptor analogues on cardiovascular death, myocardial infarction, stroke and hospitalization for heart failure. Diabetes Res Clin Pract. 2019;150:8-16. doi:10.1016/j.diabres.2019.02.014.Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375:1834-44. doi:10.1056/NEJMoa1607141.Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375:1834-44. doi:10.1056/NEJMoa1607141.Kosiborod M, Lam CSP, Kohsaka S, et al. Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study. J Am Coll Cardiol. 2018;71(23):2628-39. doi:10.1016/j.jacc.2018.03.009.Kosiborod M, Lam CSP, Kohsaka S, et al. Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study. J Am Coll Cardiol. 2018;71(23):2628-39. doi:10.1016/j.jacc.2018.03.009.Zheng SL, Roddick AJ, Aghar-Jaffar R, et al. Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA. 2018;319(15):1580-91. doi:10.1001/jama.2018.3024.Zheng SL, Roddick AJ, Aghar-Jaffar R, et al. Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA. 2018;319(15):1580-91. doi:10.1001/jama.2018.3024.Ferrannini E. Sodium-Glucose Co-transporters and Their Inhibition: Clinical Physiology. Cell Metab. 2017;26(1):27-38. doi:10.1016/j.cmet.2017.04.011.Ferrannini E. Sodium-Glucose Co-transporters and Their Inhibition: Clinical Physiology. Cell Metab. 2017;26(1):27-38. doi:10.1016/j.cmet.2017.04.011.Udell JA, Yuan Z, Rush T, et al. Cardiovascular Outcomes and Risks After Initiation of a Sodium Glucose Cotransporter 2 Inhibitor: Results From the EASEL Population-Based Cohort Study (Evidence for Cardiovascular Outcomes With Sodium Glucose Cotransporter 2 Inhibitors in the Real World). Circulation. 2018;137(14):1450-9. doi:10.1161/CIRCULATIONAHA.117.031227.Udell JA, Yuan Z, Rush T, et al. Cardiovascular Outcomes and Risks After Initiation of a Sodium Glucose Cotransporter 2 Inhibitor: Results From the EASEL Population-Based Cohort Study (Evidence for Cardiovascular Outcomes With Sodium Glucose Cotransporter 2 Inhibitors in the Real World). Circulation. 2018;137(14):1450-9. doi:10.1161/CIRCULATIONAHA.117.031227.Avogaro A, Delgado E, Lingvay I. When metformin is not enough: Pros and cons of SGLT2 and DPP-4 inhibitors as a second line therapy. Diabetes Metab Res Rev. 2018;34(4):e2981. doi:10.1002/dmrr.2981.Avogaro A, Delgado E, Lingvay I. When metformin is not enough: Pros and cons of SGLT2 and DPP-4 inhibitors as a second line therapy. Diabetes Metab Res Rev. 2018;34(4):e2981. doi:10.1002/dmrr.2981.

The authors declare that there are no conflicts of interest present.