Innovative hypoglycemic technologies in the practice of general physician


DOI: https://dx.doi.org/10.18565/therapy.2020.8.64-73

Demidova T.Yu., Izmailova M.Ya., Lobanova K.G.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Cardiovascular diseases are the leading cause of death in patients with type 2 diabetes. This served as the basis for the development of fundamentally new approaches to glucose-lowering therapy. In addition to glycemic control, early correction of risk factors for cardiovascular diseases, including arterial hypertension, dyslipidemia, and obesity is important in minimizing the risk of late complications of diabetes. Glucagon-like peptide-1 receptor agonists have emerged as a promising therapeutic class based on incretin therapy that regulates glucose metabolism through a variety of mechanisms. The pathogenetic approach to the treatment of type 2 diabetes suggests the greatest validity in the appointment of this therapy (including semaglutide) and at the earliest stages of the disease.
Keywords: semaglutide, Кeywords: type 2 diabetes, glucagon-like peptide-1 receptor agonists, cardiovascular disease
Read entire article

Literature


  1. Rosengren A. Cardiovascular disease in diabetes type 2: current concepts. J Intern Med. 2018; 284(3): 240–53. doi: 10.1111/joim.12804.

  2. IDF Diabetes Atlas. 9th edition. 2019. URL: https://www.diabetesatlas.org/upload/resources/2019/IDF_Atlas_9th_Edition_2019.pdf (date of access – 01.11.2020).

  3. Шестакова М.В., Викулова О.К., Железнякова А.В. с соавт. Эпидемиология сахарного диабета в Российской Федерации: что изменилось за последнее десятилетие? Терапевтический архив. 2019; 10: 4–13. [Shestakova M.V., Vikulova O.K., Zheleznyakova A.V. et al. Diabetes epidemiology in Russia: what has changed over the decade? Terapevticheskiy arkhiv. 2019; 10: 4–13 (In Russ.)]. doi: 10.26442/00403660.2019.10.00036.

  4. Дедов И.И., Шестакова М.В., Викулова О.К. соавт. Сахарный диабет в Российской Федерации: распространенность, заболеваемость, смертность, параметры углеводного обмена и структура сахароснижающей терапии по данным Федерального регистра сахарного диабета, статус 2017 г. Сахарный диабет. 2018; 3: 144–159. Dedov I.I., Shestakova M.V., Vikulova O.K. et al. Diabetes mellitus in Russian Federation: prevalence, morbidity, mortality, parameters of glycaemic control and structure of glucose lowering therapy according to the federal diabetes register, status 2017. Sakharniy diabet. 2018; 3: 144–159 (In Russ.)]. doi: 10.14341/DM9686

  5. Buse J.B., Wexler D.J., Tsapas A. et al. 2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2020; 63(2): 221–82. doi: 10.1007/s00125-019-05039-w.

  6. del Olmo-Garcia M.I., Merino-Torres J.F. GLP-1 receptor agonists and cardiovascular disease in patients with type 2 diabetes. J Diabetes Res. 2018; 2018: 4020492. doi: 10.1155/2018/4020492.

  7. Schnell O., Ryden L., Standl E., Ceriello A. Updates on cardiovascular outcome trials in diabetes. Cardiovasc Diabetol. 2017; 16: 128. doi: 10.1186/s12933-017-0610-y.

  8. Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет. 2016; 2: 104–112. [Dedov I.I., Shestakova M.V., Galstyan G.R. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Sakharniy diabet. 2016; 2: 104–112 (In Russ.)]. doi: 10.14341/DM2004116-17.

  9. Hsueh W.A., Orloski L., Wyne K. Prediabetes: The importance of early identification and intervention. Postgrad Med. 2010; 122(4): 129–43. doi: 10.3810/pgm.2010.07.2180.

  10. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of compliations in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.

  11. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352: 854–65.

  12. Lorber D. Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2014; 7: 169–83. doi: 10.2147/DMSO.S61438.

  13. American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes-2020. Diabetes Care. 2020; 43(Suppl 1): S66–S76. doi: 10.2337/dc20-S006.

  14. Cosentino F., Grant P.J., Aboyans V. et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020; 41(2): 255–23. doi: 10.1093/eurheartj/ehz486.

  15. Дедов И.И., Шестакова М.В., Майоров А.Ю. с соавт. Алгоритмы специализированной медицинской помощи больным сахарным диабетом под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 9-й выпуск. Сахарный диабет. 2019; S1–1: 1–144. [Dedov I.I., Shestakova M.V., Mayorov A.Y. et al. Standards of specialized diabetes care. Ed. by Dedov I.I., Shestakova M.V., Mayorov A.Yu. 9th edition. Sakharniy diabet. 2019; S1–1: 1–144 (In Russ.)]. doi: 10.14341/DM221S1.

  16. ADVANCE Collaborative Group; Patel A., MacMahon S., Chalmers J. et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008; 358(24): 2560–72. doi: 10.1056/NEJMoa0802987.

  17. Duckworth W., Abraira C., Moritz T. et al. VADT Investigators. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009; 360(2): 129–39. doi: 10.1056/NEJMoa0808431.

  18. Action to Control Cardiovascular Risk in Diabetes Study Group; Gerstein H.C., Miller M.E., Byington R.P. et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008; 358(24): 2545–59. doi: 10.1056/NEJMoa0802743.

  19. Zinman B., Lachin J.M., Inzucchi S.E. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2016; 374(11): 1094. doi: 10.1056/NEJMc1600827.

  20. Marso S.P., Daniels G.H., Brown-Frandsen K. et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016; 375(4): 311–22. doi: 10.1056/NEJMoa1603827.

  21. Wiviott S.D., Raz I., Bonaca M.P. et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019; 380(4): 347−57. doi: 10.1056/NEJMoa181238.

  22. Cannon C.P., McGuire D.K., Pratley R. et al. Design and baseline characteristics of the eValuation of ERTugliflozin effIcacy and Safety CardioVascular outcomes trial (VERTIS-CV). Am Heart J. 2018; 206: 11−23. doi: 10.1016/j.ahj.2018.08.016.

  23. Packer M., Anker S.D., Butler J. et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020; 383(15): 1413−24. doi: 10.1056/NEJMoa2022190.

  24. McMurray J.J.V., DeMets D.L., Inzucchi S.E. et al. DAPA-HF Committees and Investigators. The dapagliflozin and prevention of adverse-outcomes in heart failure (DAPA-HF) trial: baseline characteristics. Eur J Heart Fail. 2019; 21(11): 1402−11. doi: 10.1002/ejhf.1548.

  25. Gerstein H.C., Hart R., Colhoun H.M. et al. The effect of dulaglutide on stroke: an exploratory analysis of the REWIND trial. Lancet Diabetes Endocrinol. 2020; 8(2): 106–14. doi: 10.1016/S2213-8587(19)30423-1.

  26. Marso S., Bain S.C., Consoli A. et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016; 375(19): 1834–44. doi: 10.1056/NEJMoa1607141.

  27. Food and Drug Administration. Guidance for industry on diabetes mellitus – evaluating cardiovascular risk in new antidiabetic therapies to treat type 2 diabetes. 2008. URL: https://www. govinfo.gov/content/pkg/FR-2008-12-19/pdf/E8-30086.pdf (date of access – 01.11.2020).

  28. Singh S., Wright E.E. Jr, Kwan A.Y.M. et al. Glucagonlike peptide1 receptor agonists compared with basal insulins for the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Obes Metab. 2017; 19(2): 228–38. doi: 10.1111/dom.12805.

  29. Htike Z.Z., Zaccardi F., Papamargaritis D. et al. Efficacy and safety of glucagon-like peptide-1 receptor agonists in type 2 diabetes: A systematic review and mixed-treatment comparison analysis. Diabetes Obes Metab. 2017; 19(4): 524–36. doi: 10.1111/dom.12849.

  30. Dhiren P. Glycaemic and non-glycaemic efficacy of once-weekly GLP-1 receptor agonists in people with type 2 diabetes. J Clin Pharm Ther. 2020; 45 Suppl 1 (Suppl 1): 28–42. doi: 10.1111/jcpt.13224.

  31. Abdul-Ghani M., DeFronzo R.A. Is it time to change the type 2 diabetes treatment paradigm? Yes! GLP-1 RAs should replace metformin in the type 2 diabetes. Diabetes Care. 2017; 40(8): 1121–27. doi: 10.2337/dc16-2368.

  32. Kalra S., Das A.K., Sahay R.K. et al. Consensus recommendations on GLP-1 RA use in the management of type 2 diabetes mellitus: South Asian Task Force. Diabetes Ther. 2019; 10(5): 1645–717. doi: 10.1007/s13300-019-0669-4.

  33. Kalra S., Sahay R. A review on semaglutide: an oral glucagon-like peptide 1 receptor agonist in management of type 2 diabetes mellitus. Diabetes Ther. 11, 1965–1982 (2020).

  34. Witkowski M., Wilkinson L., Webb N. et al. A systematic literature review and network meta-analysis comparing once-weekly semaglutide with other GLP-1 receptor agonists in patients with type 2 diabetes previously receiving 1–2 oral anti-diabetic drugs. Diabetes Ther. 2018; 9(3): 1149–67. doi: 10.1007/s13300-018-0424-2.

  35. Thrasher J. Pharmacologic management of type 2 diabetes mellitus: available therapies. Am J Med. 2017; 130(6S): S4–S17. doi: 10.1016/j.amjmed.2017.04.004.

  36. Jensen L., Helleberg H., Roffel A. et al. Absorption, metabolism and excretion of the GLP-1 analogue semaglutide in humans and nonclinical species. Eur J Pharm Sci. 2017; 104: 31–41. doi: 10.1016/j.ejps.2017.03.020.

  37. Sorli C., Harashima S.I., Tsoukas G.M. et al. Efficacy and safety of once-weekly semaglu- tide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017; 5(4): 251–60. doi: 10.1016/S2213-8587(17)30013-X.

  38. Ahren B., Masmiquel L., Kumar H. et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56-week, double-blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol. 2017; 5(5): 341–54. doi: 10.1016/S2213-8587(17)30092-X.

  39. Ahmann A.J., Capehorn M., Charpentier G. et al. Efficacy and safety of once-weekly semaglutide versus exenatide ER in subjects with type 2 diabetes (SUSTAIN 3): a 56-week, open-label, randomized clinical trial. Diabetes Care. 2018; 41(2): 258–66. doi: 10.2337/dc17-0417.

  40. Aroda V.R., Bain S.C., Cariou B. et al. Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial. Lancet Diabetes Endocrinol. 2017; 5(5): 355–66. doi: 10.1016/S2213-8587(17)30085-2.

  41. Rodbard H.W., Lingvay I., Reed J. et al. Semaglutide added to basal insulin in type 2 diabetes (SUSTAIN 5): a randomized, controlled trial. J Clin Endocrinol Metab. 2018; 103(6): 2291–301. doi: 10.1210/jc.2018-00070.

  42. Pratley R.E., Aroda V.R., Lingvay I. et al. SUSTAIN 7 investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018; 6(4): 275–86. doi: 10.1016/S2213-8587(18)30024-X.

  43. Lingvay I., Catarig A.M., Frias J.P. et al. Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): a double-blind, phase 3b, randomised controlled trial. Lancet Diabetes Endocrinol. 2019; 7(11): 834–44. doi: 10.1016/S2213-8587(19)30311-0.

  44. Zinman B., Bhosekar V., Busch R. et al. Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2019; 7(5): 356–67. doi: 10.1016/S2213-8587(19)30066-X.

  45. Capehorn M.S., Catarig A.-M., Furbergb J.K. et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab. 2020; 46(2): 100–09. doi: 10.1016/j.diabet.2019.101117.

  46. OZEMPIC (semaglutide) injection product monograph. URL: http://www.novonordisk.ca/content/dam/Canada/AFFILIATE/www-novonordisk-ca/OurProducts/PDF/ozempic-product-monograph.pdf (date of access – 01.11.2020).


About the Autors

Tatyana Yu. Demidova, MD, professor, head of the Department of endocrinology, faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 109263, Moscow, 4/1 Shkuleva Str. E-mail: t.y.demidova@gmail.com. ORCID: 0000-0001-6385-540X. eLIBRARY.RU SPIN: 9600-9796. ScopusAuthorID: 7003771623
Mariam Ya. Izmailova, resident at the Department of endocrinology, faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. ORCID: 0000-0002-1385-0245
Kristina G. Lobanova, assistant of the Department of endocrinology, faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (915) 490-76-32. E-mail: miss.sapog@mail.ru. ORCID: 0000-0002-3656-0312. eLIBRARY.RU SPIN: 6044-1684


Similar Articles

Back to Content

Бионика Медиа