Dual Drug Therapy Protects Diabetics’ Hearts and Kidneys

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The new findings, published in The Lancet Diabetes & Endocrinology, are based on a meta-analysis of 12 large-scale, placebo-controlled trials of SGLT2is involving 73,238 patients with diabetes, 3,065 of whom were already receiving GLP1-RAs…reports Asian Lite News

Using a combination of sodium-glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) is likely to offer additional protection against heart and kidney disease in patients with diabetes, according to a study. 

SGLT2is, also called gliflozins, are a class of drugs that lower blood glucose by increasing its excretion in the urine, while GLP-1RAs, such as Ozempic, work by enhancing insulin release and sensitivity.

Impaired glucose control in patients with diabetes is known to cause damage to blood vessels in the heart and kidneys.

According to lead author Brendon Neuen, Clinical Associate Professor from The George Institute for Global Health, “the rapidly expanding indications for the use of GLP-1 receptor agonists, makes it important to look at their effects with SGLT2 inhibitors”.

The new findings, published in The Lancet Diabetes & Endocrinology, are based on a meta-analysis of 12 large-scale, placebo-controlled trials of SGLT2is involving 73,238 patients with diabetes, 3,065 of whom were already receiving GLP1-RAs.

The results showed that SGLT2is reduced the risk of heart attack, stroke, or cardiovascular death by 11 per cent, independent of GLP1-RAs.

It also decreased hospitalisation for heart failure or cardiovascular death by 23 per cent versus placebo, even when added to GLP1-RAs.

Further, the drug SGLT2is also reduced the risk of chronic kidney disease progression by 33 per cent when added to GLP1-RAs and slowed the annual loss of kidney function by almost 60 per cent when added to GLP-1RAs.

Importantly, no new safety concerns were identified when SGLT2is and GLP-1RAs were used in combination, the team said.

Both classes of medicines work independently of each other — SGLT2 inhibitors against heart failure and chronic kidney disease; GLP-1 receptor agonists against heart attack, stroke, and also kidney disease, Neuen said.

Hidden Dangers for Newborns and Weakened Immune Systems

Cytomegalovirus (CMV) is a common and symptomless herpes virus that can cause serious harm to newborn babies and people with impaired immune systems like organ transplant and HIV patients, said experts here on Saturday.

CMV belongs to the herpes virus family and can infect people of all ages. It spreads through body fluids and usually remains dormant, causing no symptoms or a mild illness characterised by fever, sore throat, fatigue, or swollen glands.

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But it can prove to be risky for some people. CMV is the most commonly transmitted virus to a developing foetus.

In people with weaker immune systems, CMV can produce serious symptoms affecting the eyes, lungs, oesophagus, intestines, stomach, or liver.

“If a pregnant woman contracts CMV for the first time during pregnancy (primary infection), there is a risk of transmitting the virus to the unborn baby. This can result in congenital CMV infection, which may cause developmental problems, hearing loss, vision impairment, and other serious health issues in the baby,” Dr Neha Rastogi Panda, Consultant-Infectious Diseases, Fortis Memorial Research Institute, Gurugram, told.

“CMV is a common virus that infects over 90 per cent of the Indian population during pregnancy (intrauterine) or early childhood. While typically harmless in healthy individuals, CMV can become a serious threat to people with HIV/AIDS or those undergoing organ transplants (especially kidney and bone marrow). In these cases, the virus can reactivate and cause a range of health problems,” added Dr Rajeev Gupta, Director – Internal Medicine at the CK Birla Hospital (R), Delhi.

CMV in people with low immunity on steroids, cancer, and dialysis can reactivate and cause symptoms like fever, pneumonia, gastrointestinal symptoms, and visual effects and problems.

Dr Neha said that CMV is a significant cause of morbidity and mortality in people with weakened immune systems.

While there is no widely available vaccine specifically to prevent the initial infection with CMV, antiviral medications administered during organ transplant procedures significantly reduce the risk of CMV reactivation.

The doctors called for maintaining hygiene by washing hands regularly, practising safe sex, not sharing items like toothbrushes, and avoiding contact with bodily fluids.

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