Woman with diabetes has blood sample taken by a nurse. Her medications are on the table in front of her.
Diseases & Conditions

Diabetes Drugs That Protect Heart and Kidneys, Too

By on 10/09/2020

A researcher at Einstein Medical Center Philadelphia has chaired a Scientific Statement from the American Heart Association that could dramatically impact the treatment of patients with Type 2 diabetes, a disease that is pervasive in Einstein’s patient community.

Janani Rangaswami, MD, associate chair of research in the Department of Internal Medicine, was the lead author of the AHA statement, which appeared on September 28 in the journal Circulation.

Janani Rangaswami, MD

Dr. Rangaswami and her co-authors reviewed multiple large studies and concluded that two newer classes of anti-diabetes drugs have been found to “significantly” reduce the heart problems and accelerated kidney disease that are a complication of diabetes. But medical care is so often fragmented that only 7% of the patients who could benefit from the medications are taking them.

“A collaborative treatment approach among primary care doctors and specialists in diabetes, cardiology and kidney disease that may include treatment with these two classes of medication could add more heart- and kidney-disease-free years and greatly extend survival for people with Type 2 diabetes,” the statement says.

Einstein ‘Ahead of the Curve’

Einstein has already adopted this collaborative model, Dr. Rangaswami says. “I think we are on the front end of the curve. Having a multidisciplinary model comes at a critical time when rates of heart and kidney disease continue to soar and healthcare costs, associated costs and poor outcomes are placing a huge burden on patients and health systems.”

According to 2018 statistics from the American Diabetes Association, one out of 10 Americans has diabetes – more than 30 million people.  People with diabetes are at increased risk of serious health complications, including premature death, vision loss, heart disease, stroke, kidney failure, and amputation of toes, feet or legs.  

Einstein serves a population that is largely minority and underserved and is particularly beset with diabetes and its complications.

Dr. Rangaswami and her team reviewed evidence from multiple randomized controlled trials of two classes of blood sugar medications. They determined that the medicines “significantly reduce the risk of cardiovascular events and death, reduce hospitalization and slow the progression of chronic kidney disease including the risks of dialysis, transplantation or death,” according to a press release from the AHA.

Heart- and Kidney-Protecting Diabetes Drugs

One group of drugs is known as sodium glucose co-transporter 2 inhibitors, which first received FDA approval in 2013. The drugs in this class are canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance). Glucagon-like peptide-1 receptor agonists, first approved in 2005, include dulaglutide (Trulicity), exenatide (Byetta) and liraglutide (Victoza), among others.

Scientific statements are designed to help the medical community stay informed about developments in research that could influence treatment protocols. These relatively new anti-diabetic drugs have been the subject of multiple large, international drug trials. The statement authored by Dr. Rangaswami is designed to synthesize and summarize the research findings.  

Kevin Bryan Lo, MD, a former chief resident at Einstein, was one of the co-authors of the scientific statement. Dr. Rangaswami is also an associate clinical professor at the Sidney Kimmel Medical College of Thomas Jefferson University.

Learn more about Einstein’s diabetes specialists.

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