Abstract
To the editor regarding article \u201cCoadministration of DPP-4 inhibitor and insulin therapy does not further reduce the risk of cardiovascular events compared with DPP-4 inhibitor therapy in diabetic foot patients: a nationwide population-based study\u201d
Highlights
With great interest we read the article by Lin et al [1] about the effect of insulin and DPP4i therapy on the development of major adverse cardiovascular events in patients with diabetic foot syndrome
In the case of persistent hyperglycemia on oral anti-diabetic agents as well as in patients with initially very high plasma glucose levels, insulin remains the only option left for these patients
These are typically patients with advanced type 2 diabetes with increased insulin resistance and impaired peripheral insulin sensitivity, respectively, which has been repeatedly associated with adverse cardiovascular outcome and a high mortality rate [4, 5]
Summary
With great interest we read the article by Lin et al [1] about the effect of insulin and DPP4i therapy on the development of major adverse cardiovascular events in patients with diabetic foot syndrome. Insulin therapy is a cornerstone therapy for many patients with type 2 diabetes [2, 3]. Initial treatment of type 2 diabetes should ideally start with the modification of life-style factors and, if insufficient, should be followed by the initiation of oral anti-diabetic drugs. In the case of persistent hyperglycemia on (additional) oral anti-diabetic agents as well as in patients with initially very high plasma glucose levels, insulin remains the only option left for these patients.
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