Diabetes drug reduces heart attack risk

The findings suggested canagliflozin reduced the risk of cardiovascular disease by 14 per cent and also lowered the risk of hospitalisation relating to heart failure by 33 per cent.

With coronary heart disease the biggest killer of people with type 2 diabetes, Australian researcher Professor Bruce Neal of The George Institute for Global Health says the findings offer real hope to the thousands of Australians with the disease.

The risk of amputations of toes or feet was double in patients who took Invokana compared with those who took placebo in studies that involved 10,142 type 2 diabetes patients.

Because these issues are strongly linked to type two diabetes, the drug could make a huge difference to the four million people in the United Kingdom who have the disease.

The new data comes from two separate trials and was presented at the American Diabetes Association (ADA) 2017 Scientific Sessions.

Metformin is now recommended for those with the condition to reduce insulin intake and stabilise weight, but its effects on the heart and blood vessels have been unknown. The findings were cited as particularly relevant to Australia where around 65%of cardiovascular deaths occur in people with diabetes or pre-diabetes, and diabetes is also the leading cause of end-stage kidney disease. But the new study reveals the £1.30 a day drug also has a remarkable impact on cardiovascular problems and kidney disease.

Executive Director of The George Institute Australia, co-author Prof.

The REMOVAL trial is the largest clinical trial of metformin therapy in type 1 diabetes to date and has provided clinically meaningful data on metformin's potential to reduce the risk of developing cardiovascular disease.

Canagliflozin, known as a SGLT2 inhibitor, is a relatively new type of drug that works by blocking the body's reabsorption of sugar or glucose.

"Care is warranted in the use of canagliflozin in patients at risk for amputation", a New England Journal of Medicine article on the study said. This causes in more glucose being released in the urine which thereby reduces the glucose levels of blood. Less positive was a doubling in risk of amputations associated with canagliflozin use.

It is recommended by watchdog NICE for patients for whom diet and exercise are not sufficient to keep blood sugar down, and for whom a much more common drug called metformin does not work. A warning of increased amputation risk was added to Invokana's prescribing label after it was discovered by safety monitors during an interim analysis of the study.

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