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Primary Care

Closing the knowledge gap on cardiovascular disease in type 2 diabetes: the EMPA-REG OUTCOME trial and beyond

Authors: Elif A Oral

This paper summarizes the results from the ground-breaking EMPA-REG OUTCOME study and discusses their significance and clinical implications.

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Influenza vaccination: key facts for general practitioners in Europe—a synthesis by European experts based on national guidelines and best practices in the United Kingdom and the Netherlands

Authors: George Kassianos, Patricia Blank, Oana Falup-Pecurariu, Ernest Kuchar, Jan Kyncl, Raul Ortiz De Lejarazu, Aneta Nitsch-Osuch, Gerrit A Van Essen

In this article the authors aim to harmonise the diagnosis of seasonal influenza and the approach of European general practitioners to vaccination in order to better identify influenza outbreaks and achieve a target vaccination rate of 75% throughout Europe.

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Anticoagulation for the prevention of stroke in non-valvular AF in general practice: room for improvement

Authors: Adam Ioannou, Sofia Metaxa, George Kassianos, Constantinos G Missouris

The aim of this study was to assess whether the recommendations and guidelines for thromboprophylaxis in patients with atrial fibrillation (AF) have been adopted in general practice (GP) in the UK. The authors concluded that one in four patients with non-valvular AF, at risk of a stroke, is not being adequately treated with an oral anticoagulant in primary care and suggest that a review of GP practice databases should be considered to identify patients with non-valvular AF, at risk of a disabling or fatal event, and measures taken to initiate anticoagulant therapy.

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Effectiveness, tolerability and practical application of the newer generation anti-obesity medications

Authors: Jeffrey S MacDaniels, Thomas L Schwartz

In this paper, the authors compare the efficacy and tolerability of five newer anti-obesity medications to guide clinical decision making, examining bupropion–naltrexone combination, liraglutide, lorcaserin, orlistat, and phentermine–topiramate combination.

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Combination therapy in type 2 diabetes mellitus: adding empagliflozin to basal insulin

Authors: Andrew Ahmann

Type 2 diabetes mellitus (T2DM) management is complex, with few patients successfully achieving recommended glycemic targets with monotherapy, most progressing to combination therapy, and many eventually requiring insulin. Sodium glucose cotransporter 2 (SGLT2) inhibitors are an emerging class of antidiabetes agents with an insulin-independent mechanism of action, making them suitable for use in combination with any other class of antidiabetes agents, including insulin. In this review the evaluates a 78-week, randomized, double-blind, placebo controlled trial investigating the impact of empagliflozin, an SGLT2 inhibitor, as add-on to basal insulin in patients with inadequate glycemic control on basal insulin, with or without metformin and/or a sulfonylurea.

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