title: Antihyperglycemic drugs and cardiovascular outcomes in type 2 diabetes.
abstract: In patients with diabetes, a complex and controversial relationship exists between intensive glycemic control and cardiovascular (CV) outcomes. Although the value of glucose-lowering agents in preventing microvascular complications associated with diabetes has been established, along with reductions in ischemic coronary events, active treatment in one major glycemic-control trial resulted in an unexplained increase in CV-associated mortality and total deaths compared with controls. Questions of CV safety with specific glucose-lowering agents along with the mechanisms underlying their effects on CV events have not been fully answered, underscoring the need for additional well-designed, long-term randomized controlled trials (RCTs) to prove their CV safety vs an active comparator. The CV benefits of one sodium-glucose cotransporter-2 inhibitor reported in an RCT await confirmation in ongoing trials.
authors.affiliation: Clinical Research and Adult Diabetes Sections, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA. E-mail: om.ganda@joslin.harvard.edu.
authors.forename: Om P
authors.initials: OP
authors.lastname: Ganda
mesh_terms: D001786:Blood Glucose / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents