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December 2021 -
Volume 19, Issue 12


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From the Editor

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Knowledge around back pain and spinal disorders among Aseer patients: A cross sectional study
[Abstract]
[pdf]
Ibrahim Alburaidi, Saleh Saeed AlQahtani, Fahad mohammed saran, Zuhair Abshan Alshehri,
Rayan Dulaym Dashnan, Sultan Abdullah Al Mansour, Faisal al-Jahami, Shaker Alshehri,
Hani Fayez Ahmed Alasmari, Jamal Saad Saeed Alqahtani, Meshari Shar Alshehri
DOI: 10.5742/MEWFM.2021.94171

Environmental Triggers in Migraine patients in Riyadh: A Cross-Sectional Study
[Abstract]

[pdf]
Awad Al Harbi, Nada Hussain Alzahrani, Hanan Abdulkarim Alsuhibany, Manal Abdullah Al-Dosari, Reeman Salman Alsalman, Alanoud Abdulaziz Alkhalifah (2)
DOI: 10.5742/MEWFM.2021.94172

Job Satisfaction among Primary Health Care Workers in Buraidah, Qassim, Saudi Arabia
[Abstract]
[pdf]
Entisar AlJumail, Unaib Rabbani
DOI: 10.5742/MEWFM.2021.94173

Barriers to Compliance of Hypertensive Patients in Abha City, Saudi Arabia
[Abstract]
[pdf]
Alhussein Ali Almonawar, Ali Saeed Alasmary, Mohammed Mabkhoot Mogbel,
Hassan Mussa Almojamad
DOI: 10.5742/MEWFM.2021.94177

Disappearance of hepatitis C virus antibodies with hydroxyurea therapy in sickle cell diseases
[Abstract]
[pdf]
Mehmet Rami Helvaci, Engin Altintas, Atilla Yalcin, Orhan Ekrem Muftuoglu, Abdulrazak Abyad, Lesley Pocock
DOI: 10.5742/MEWFM.2021.94177

School Teachers' Knowledge and Attitude toward School Students with Epilepsy
[Abstract]
[pdf]
Rawan S. AlSuqair,Mohrah A. Alyabis,Marwa A. Algadi, Asmaa Attieh, Labani A. Juha,
Rama G. Alawa, Sarah G. Alghannam, Noora Z. Alsaadoon, Nervana A. Elsayed, Mona A. Alfadeel
DOI: 10.5742/MEWFM.2021.94183

Regional Covid

Increased Psychological Disorders among Pediatric Population during Covid
[Abstract]
[pdf]
Hamda Ahmed J H AlQaatri
DOI: 10.5742/MEWFM.2021.94174

Letter to the Editor
[pdf]
Mark Spigelman
DOI: 10.5742/MEWFM.2021.94192

Population and Community Studies

Patterns and determinants of Z score of Height for Age, Weight for Age and Weight for Height among Preschool children in Jeddah city, Saudi Arabia
[Abstract]
[pdf]
Fathi M. El-Gamal, Nuha Alsubhi, Shahd Badr, Nada Althaqafi, Fatima Al-Qadasi, Mariyam Hammed DOI: 10.5742/MEWFM.2021.94179

Effectiveness of Community Mental Health Service in Oman: A Pilot Study
[Abstract]
[pdf]
Saleha Al-Jadidi, Ahmed. S. Aboalatta, Iman Al-Rahbi, Maryiam Al-Harrasi,
Hamood AlRauzaiqi, Musa Abu Sabeih, Thuraiya AlGammari, Ahmed Al-Shammakhi
DOI: 10.5742/MEWFM.2021.94180

Proton Pump Inhibitors Awareness among Physicians and Pharmacists in Primary Healthcare Centres in Abha, Saudi Arabia
[Abstract]
[pdf]
Ibrahim Hasan Alasmari, Majed Mohammed AL Saleh, Majed Ali Alahmari, Sawsan Mohammad Asiri, Aljawhara Yahya Asiri
DOI: 10.5742/MEWFM.2021.94184

Knowledge, Attitude and Practice of Non-Psychiatric Physicians about Addiction
[Abstract]
[pdf]
Saeed M. Al-Ahmari, Ali A. Almusa, Ali A. Alshomrani, Waleed S.H. Al Ahmary,
Zahra S.A. Assiry, Suad M.S. Alqahtany, Ahmed Yahya Asiri, Turki Hassan Alqahtani,
Nasser Saeed Alassiri, Ossama A. Mostafa
DOI: 10.5742/MEWFM.2021.94185

Risk Factors for Diabetic Ketoacidosis among Type 1 Diabetic Children Registered at "Heraa Diabetes Center" in Makkah Al-Mokarramah City, Saudi Arabia
[Abstract]
[pdf]
Waleed K. Ballaji, Hassan M. Hadadi
DOI: 10.5742/MEWFM.2021.94186

Physicians’ Perspectives of Barriers to Insulin Initiation for Adults with Type 2 Diabetes Mellitus in Primary Health Care Centers (PHCCs), Tabouk Province - Kingdom of Saudi Arabia (KSA)
[Abstract]
[pdf]
Sameh F. Ahmed, Ghurmallah A. Alghamdi, Amerah A. Albalawi, Majed S. Alqahtani, Ibrahim M. Ghonim, Hoda M. Elhady, Shimaa A. Abdelhamid, Abderahman A. Eldesouky
DOI: 10.5742/MEWFM.2021.94189

Review

Role of SGLT2 Inhibitors and GLP-1 Analogs in Cardiovascular Risk Reduction in Type 2 Diabetes
[Abstract]
[pdf]
Mostafa Hamdy Rashed, Tonbra Deborah Dauyoumor, Sarah Corney,
Kimberly Konono, Nadia Joubert, Marwa Mohamed, Michon Sukhoo-Pertab,
Mobowa Makhomisane, Irene Njeri, Julius Mwita, Mariam Sefen,
Khadija Mohamed, Nicolette Whiley
DOI: 10.5742/MEWFM.2021.94188

Diagnostic approach to eosinophilia in children
[Abstract]
[pdf]
Raghba Shasho
DOI: 10.5742/MEWFM.2021.94190

Original Clinical Research

Machine Learning in Otorhinolaryngology, Head and Neck Surgery and its applications in diagnosis and management: Undergraduates Perception toward New Era
[Abstract]
[pdf]
Saleh Abdulmoneim Alomary, Belal Abdullah Alorainy , Naif Saleh Albargan, Fahad Z. Alotaibi
Feras Alkholaiwi
DOI: 10.5742/MEWFM.2021.94191

Middle East Quality Improvement Program
(MEQUIP QI&CPD)


Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE

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Publisher -
Lesley Pocock
medi+WORLD International
AUSTRALIA
Email
: lesleypocock@mediworld.com.au
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December 2021 - Volume 11, Issue 12

Role of SGLT2 Inhibitors and GLP-1 Analogs in Cardiovascular Risk Reduction in Type 2 Diabetes

(1) Primary Health Care Corporation, Doha, Qatar.
(2) National Health Service, United Kingdom.
(3) Ely Bridge Surgery, Cardiff, Wales.
(4) Chinhoyi Provincial Hospital, Chinhoyi, Zimbabwe.
(5) Diabetes Care Centre, Centurion, South Africa.
(6) Abudhabi, United Arab Emirates.
(7) St. George’s University in Grenada, West Indies.
(8) Metropolitan Medical Center, Polokwane, South Africa
(9) Kiambu County Referral Hospital, Kiambu County, Kenya
(10) Gaborone, Botswana.
(11) National Institute of Diabetes and Endocrinology, Egypt
(12) The Aga Khan University Hospital, Nairobi, Kenya.
(13) Johannesburg, South Africa

Corresponding author:
Dr. Mostafa Hamdy Rashed
Primary Health Care Corporation, Doha, Qatar
Email: mostafa.rashed86@hotmail.com

Received: October 2021; Accepted: November 2021; Published: December 1, 2021.
Citation: Mostafa Hamdy Rashed et al. Role of SGLT2 Inhibitors and GLP-1 Analogs in Cardiovascular Risk Reduction in Type 2 Diabetes. World Family Medicine. 2021; 19(12): 105-114 DOI: 10.5742/MEWFM.2021.94188

Abstract


The leading cause of morbidity and mortality in patients with type-2 diabetes mellitus is cardiovascular (CV) disease, which makes it an important target in management. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonist (GLP-1 RA) are both two new antidiabetic drug classes that showed significant reduction in major cardiovascular events (MACE). With the introduction of these drugs, comprehensive CV risk reduction has been achieved in addition to glucose control. Both drugs work in different ways; the SGLT-2 Inhibitors lead to urinary excretion of 60-90 grams of glucose as well as sodium leading to osmotic diuresis. On the other hand, GLP-1 agonists affect postprandial glucose by enhancing insulin secretion in the beta cells and inhibition of glucagon secretion in the alpha cells in a glucose dependent manner. Different types of drugs are discussed in detail according to different trials such as EMPA-REG, EMPEROR REDUCED, CANVAS, CREDENCE, VERTIS-CV, DAPA-HF and DECLARE TIMI 58 for SGLT-2 Inhibitors, while for GLP-1 agonists, trials such as ELIXA, FREEDOM, EXCEL, LEADER, SUSTAIN, PIONEER 6, REWIND and HARMONY. According to U.S. Drug and Food Administration guidance in 2008, it is required that all new oral hypoglycemic agents undergo cardiovascular outcome trials to evaluate CV safety. Both the SGLT2 inhibitors and GLP-1 agonists have undergone large trials that have led to massive evidence on their cardiovascular safety and renal benefits. The decision on using which drug from both classes depends on different factors like atherosclerotic disease and chronic Kidney disease.

Key words. diabetes, cardiovascular, reduction







 


 

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