Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 16, Pages -Publisher
MDPI
DOI: 10.3390/jcm11164660
Keywords
diabetes; heart failure with preserved ejection fraction (HFpEF); heart failure with reduced ejection fraction (HFrEF); oxidative stress; metformin; SGLT2 inhibitors; thiazolidinediones; sulfonylureas; dipeptidyl peptidase 4 inhibitors; glucagon-likepeptide-1 receptor agonists
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Diabetes mellitus and heart failure are chronic disorders that affect millions of people worldwide. Hyperglycemia-induced oxidative stress plays a significant role in the progression of diabetes and its complications. Antidiabetic drugs have various effects on heart failure and oxidative stress in diabetic patients, with some drugs showing potential benefits and others being not recommended.
Diabetes mellitus (DM) and heart failure (HF) are two chronic disorders that affect millions worldwide. Hyperglycemia can induce excessive generation of highly reactive free radicals that promote oxidative stress and further exacerbate diabetes progression and its complications. Vascular dysfunction and damage to cellular proteins, membrane lipids and nucleic acids can stem from overproduction and/or insufficient removal of free radicals. The aim of this article is to review the literature regarding the use of antidiabetic drugs and their role in glycemic control in patients with heart failure and oxidative stress. Metformin exerts a minor benefit to these patients. Thiazolidinediones are not recommended in diabetic patients, as they increase the risk of HF. There is a lack of robust evidence on the use of meglinitides and acarbose. Insulin and dipeptidyl peptidase-4 (DPP-4) inhibitors may have a neutral cardiovascular effect on diabetic patients. The majority of current research focuses on sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. SGLT2 inhibitors induce positive cardiovascular effects in diabetic patients, leading to a reduction in cardiovascular mortality and HF hospitalization. GLP-1 receptor agonists may also be used in HF patients, but in the case of chronic kidney disease, SLGT2 inhibitors should be preferred.
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