Abstract
In recent years, several new antidiabetic drugs have been developed, among which only two have demonstrated superiority in cardiovascular protection. They are liraglutide and empagliflozine, which belong, respectively, to GLP-1 RA and SGLT-2i. These medications have also shown benefits in kidney protection. However, in a recent survey of the author among nephrologists in a large colombian city, it has been detected that most do not use these drugs. The greater resistance to the limitation in its use is due to the advanced stages of chronic kidney disease where they are contraindicated, but also to the anawareness of their potential benefits. In this regard, the nephrologists accepted they should learn more about these antidiabetic medicines, because the type of patient that is frequently attended in their consultation will undoubtly benefit, and considering they are obligated to handle the diabetic patient directly.References
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13. Lorenzi M, Ploug UJ, Langer J, Skovgaard R, Zoratti M, Jansen J. Liraglutide Versus SGLT-2 Inhibitors in People with Type 2 Diabetes: A Network Meta-Analysis. Diabetes Ther 2017; 8:85-99.
14. Mann JFE, Frandsen KB, Daniels G, Kristensen P, Nauck M, Nissen S, et al. Liraglutide and renal outcomes in type 2 diabetes: results of the Leader trial. Presentado en la ASN Kidney Week, Chicago, 19-nov-2016 (resumen HI-OR01, J Am Soc Nephrol 2016; 27).
15. Wanner C, Inzucchi SE, Lachin JM, Fitchett D, von Eynatten M, Mattheus M, et al. Empagliflozin and progression of kidney disease in type 2 diabetes. New Engl J Med 2016; 375:323-34.
2. Green JB, Bethel A, Armstrong PW, Buse JB, Engel SS, Garg J, et al. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. New Engl J Med 2015; 373:232-42.
3. Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, et al. Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus. New Engl J Med 2013; 369:1317-26.
4. White WB, Cannon CP, Heller SR, Nissen SE, Bergenstal RM, Bakris GL, et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med 2013; 369: 1327-1335.
5. ClinicalTrials.gov, Cardiovascular and Renal Microvascular Outcome Study With Linagliptin in Patients With Type 2 Diabetes Mellitus (CARMELINA). 2013; NCT01897532 https://clinicaltrials.gov/ct2/ (Accedido 2 dic 2016)
6. Rosenstock J, Marx N, Kahn SE, Zinman B, Kastelein JJ, Lachin JM,et al. Cardiovascular outcome trials in type 2 diabetes and the sulphonylurea controversy: rationale for the active comparator. CAROLINA trial. Diab Vasc Dis Res 2013; 10:289-301.
7. Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Køber LV, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. New Engl J Med 2015; 373:2247-57.
8. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. New Engl J Med 2016; 375:311-22.
9. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. New Engl J Med 2016; 375:1834-44.
10. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373: 2117-28.
11. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352:854-65.
12. Idorn T, Knop FK, Jørgensen MB, Jensen T, Resuli M, Hansen PM, et al. Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease: An Investigator-Initiated, Placebo-Controlled, Double-Blinded, Parallel Group, Randomized Trial. Diabetes Care 2016; 39:206-13.
13. Lorenzi M, Ploug UJ, Langer J, Skovgaard R, Zoratti M, Jansen J. Liraglutide Versus SGLT-2 Inhibitors in People with Type 2 Diabetes: A Network Meta-Analysis. Diabetes Ther 2017; 8:85-99.
14. Mann JFE, Frandsen KB, Daniels G, Kristensen P, Nauck M, Nissen S, et al. Liraglutide and renal outcomes in type 2 diabetes: results of the Leader trial. Presentado en la ASN Kidney Week, Chicago, 19-nov-2016 (resumen HI-OR01, J Am Soc Nephrol 2016; 27).
15. Wanner C, Inzucchi SE, Lachin JM, Fitchett D, von Eynatten M, Mattheus M, et al. Empagliflozin and progression of kidney disease in type 2 diabetes. New Engl J Med 2016; 375:323-34.
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