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Endocrinology

Empagliflozin: a new sodium-glucose co-transporter 2 (SGLT2) inhibitor for the treatment of type 2 diabetes

Authors: Joshua J Neumiller

Type 2 diabetes is increasing in prevalence worldwide, and hyperglycemia is often poorly controlled despite a number of therapeutic options.

Unlike previously available agents, sodium-glucose co-transporter 2 inhibitors offer an insulin-independent mechanism for improving blood glucose levels, since they promote urinary glucose excretion by inhibiting glucose reabsorption in the kidney.

In this article, the author discusses empagliflozin and based on available data, it appears that this drug may be a useful option in a range of patients; however, clinical decisions will be better informed by the results of ongoing studies, in particular, a large cardiovascular outcome study (EMPA-REG OUTCOME™).

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Initial combination therapy for patients with type 2 diabetes mellitus: considerations for metformin plus linagliptin

Authors: Jeffrey Freeman

In this article the author discusses the implications for clinical practice of the results of a recent Phase III trial. He concludes that initial combination of linagliptin plus metformin which was found to be weight neutral, well tolerated and associated with a low frequency of hypoglycaemia, may have advantages for a large proportion of patients with type 2 diabetes, particularly those with a relatively high HbA1c at diagnosis.

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Optimizing glycemic control and minimizing the risk of hypoglycemia in patients with type 2 diabetes

Authors: Stanley S Schwartz

In this article the author argues that in type 2 diabetes, an approach that emphasizes diet and exercise and features a treatment regimen tailored to the needs of the individual to reach glycemic targets is warranted in most patients and provides microvascular and cardiovascular benefit, provided that hypoglycemia is avoided.

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Therapeutic approaches to slowing the progression of diabetic nephropathy – is less best?

Authors: Eva Vivian, Chelsea Mannebach

In this article authors review recent studies and evaluate the benefits and risks of combination therapy with an angiotensin converting enzyme (ACE) inhibitor and angiotensin II receptor blocker (ARB), or a direct renin inhibitor (DRI) to attenuate the progression of diabetic nephropathy.

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