A review on impact of glucose-lowering therapies on cardiovascular system in type 2 diabetes mellitus patients

Abstract

The prevalence of diabetes mellitus (DM), a well-renowned metabolic diseases that comes under Top-10 lethal and incurable disease of the world, is increasing day by day. It is well-reported that the mortality rate of diabetic patients due to comorbidities is higher. Diabetic patients suffer from several cardiovascular events and such risk increases with an intermediate metabolite HbA1c. Control in HbA1c and lowering it does not appear to yield the same benefit on macrovascular endpoints, as observed for microvascular endpoints. Moreover, secondary diseases caused by diabetes mellitus are many and diabetic patients have been found to be more susceptible to diseases like cardiac injury. For instance, rosiglitazone has been found to cause myocardial infarction and ultimately leads to heart failure. Glucagon like Peptide -1 (GLP-1) agonists and sodium- glucose co-transporter 2 (SGLT2) inhibitors causes several cardiac side effects like myocardial infarction and stroke. In this concern, USFDA officially announced in2008 that all new glucose-lowering agents should be tested for its cardiac safety. However, Metformin which is a biguanide has been very safe and useful for obese diabetic patients. It has shown minimal cardiovascular abnormality and has been considered as one of the safest drugs to be given diabetic patients. In this paper published scientific articles of antidiabetic drugs for their impact on cardiovascular anatomy and physiology have been summarized along with the conclusion of relevant studies.