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CARDIOVASCULAR OUTCOME IN TRIAL OF NEW ANTIDIABETIC
DRUGS
PROFESSOR / MOHAMMED AHMED BAMASHMOOS
RISK FACTORS OF CVD IN TYPE 2-DIABETIC
● 1- Hyperglycemia ; any increase in HbA1C by 1 is associated with increase in CV
mortality and morbidity by 11% - 16%
● 2- hypoglycemia ; it leads to
● - increased inflammation as CRP
● - endothelial dysfunction
● - sympatho adrenal response
● - increased adrenaline
3- weight gain and obesity ;
● - hypertension
● - dyslipidemia
● - IR
● - increased plasma volume
● - increased inflammation
● -
● 4- insulin resistance lead to ;
● - hypertension
● - atherosclerosis
● - dyslipidemia
● - endothelial dysfunction
● - hyperuricemia
● 5- endothelial dysfunction
● 6- inflammation
● 7- hyper coagulation
PATHOGENESIS
LIST OF NOVEL ANTIDIABETIC DRUGS
● 1- metformin
● 2- SGLT type 2 inhibitor
● 3- dipeptidyl peptidase type 4 inhibitor
● 4- GLP1 receptor agonist
Weight changes Neutral or gradual
decrease
Decrease by 3kg in the
first year
6.5 at 40 weeks of
treatment
Effect in lipid increase HDL , decrease total
cholesterol , decrease LDL,
VLDL,
Increase HDL Decrease Increase HDL , decrease
cholesterol , TG
Effect in IR Improve insulin
sensitivity
Decrease IR by
decreasing
glucotoxicity
Decrease IR Decrease
Effect in BP Decrease secondary to
decrease IR
Decrease BP Decrease BP, HR Decrease BP, HR
Effect in endothelial
function
Improve Improve vascular
function
Enhance function Enhance function
Inflammatory effect Decrease proinflammatory
cytokine
Decrease Decrease Decrease
Effect in coagulopathy decrease PAI type 1. increase
tissue plasminogen activator ,
decrease platelets aggregation
and adhesion )
3- GLP1 RECEPTOR AGONIST
4- DIPEPTIDYL PEPTIDASE TYPE 4 INHIBITOR
/

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cardiovascular outcome in trial of new antidiabetic drugs

  • 1. CARDIOVASCULAR OUTCOME IN TRIAL OF NEW ANTIDIABETIC DRUGS PROFESSOR / MOHAMMED AHMED BAMASHMOOS
  • 2. RISK FACTORS OF CVD IN TYPE 2-DIABETIC ● 1- Hyperglycemia ; any increase in HbA1C by 1 is associated with increase in CV mortality and morbidity by 11% - 16% ● 2- hypoglycemia ; it leads to ● - increased inflammation as CRP ● - endothelial dysfunction ● - sympatho adrenal response ● - increased adrenaline 3- weight gain and obesity ; ● - hypertension ● - dyslipidemia ● - IR ● - increased plasma volume ● - increased inflammation ● -
  • 3. ● 4- insulin resistance lead to ; ● - hypertension ● - atherosclerosis ● - dyslipidemia ● - endothelial dysfunction ● - hyperuricemia ● 5- endothelial dysfunction ● 6- inflammation ● 7- hyper coagulation
  • 5.
  • 6. LIST OF NOVEL ANTIDIABETIC DRUGS ● 1- metformin ● 2- SGLT type 2 inhibitor ● 3- dipeptidyl peptidase type 4 inhibitor ● 4- GLP1 receptor agonist
  • 7. Weight changes Neutral or gradual decrease Decrease by 3kg in the first year 6.5 at 40 weeks of treatment Effect in lipid increase HDL , decrease total cholesterol , decrease LDL, VLDL, Increase HDL Decrease Increase HDL , decrease cholesterol , TG Effect in IR Improve insulin sensitivity Decrease IR by decreasing glucotoxicity Decrease IR Decrease Effect in BP Decrease secondary to decrease IR Decrease BP Decrease BP, HR Decrease BP, HR Effect in endothelial function Improve Improve vascular function Enhance function Enhance function Inflammatory effect Decrease proinflammatory cytokine Decrease Decrease Decrease Effect in coagulopathy decrease PAI type 1. increase tissue plasminogen activator , decrease platelets aggregation and adhesion )
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. 3- GLP1 RECEPTOR AGONIST
  • 13. 4- DIPEPTIDYL PEPTIDASE TYPE 4 INHIBITOR
  • 14.
  • 15.
  • 16.
  • 17. /