Canagliflozin Associated Cardiovascular Outcomes in Type 2 Diabetes

Highlights:

Canaglifozin found to significantly lower the risk for heart failure in type 2 diabetes patients.
Type 2 diabetes patients were assessed for the risk of heart failure, particularly in patients with established or high risk for cardiovascular disease.
Canagliflozin compared with other non-SGLT2 inhibitors for its cardiovascular adverse effects.

Canagliflozin is an anti-diabetes drug belongs to the gliflozin class or sodium-glucose transport subtype two inhibitors. Canagliflozin is administered either as a monotherapy or with metformin, sulfonylurea drugs, pioglitazone or insulin to achieve adequate glycemic control while treating diabetes patients.

Canagliflozin
This medication is an antidiabetic (sodium glucose co-transporter 2 (SGLT2) inhibitor), prescribed for type 2 diabetes mellitus along with diet and exercise. For patients with type 2 diabetes along with diabetic kidney disease, physicians should consider using an SGLT2 inhibitor when the eGFR is at or above 30, especially with albuminuria above 300 mg/g, to lower renal and CV risk as per A.D.A recommendations.

‘In a thirty-month study carried out in type 2 Diabetes patients, canagliflozin showed a significant decrease in heart failure, when compared with other anti-diabetes drugs or non-SGLT2 inhibitors.’

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Canagliflozin Vs. Other Non-SGLT2 Inhibitor Drugs

Canagliflozin, a sodium-glucose cotransporter-2 inhibitor works by blocking the reabsorption of glucose in the proximal convoluted tubule found to lower the risk of cardiovascular events, particularly in patients who have a strong history of heart disease. The research team conducted a population-based retrospective cohort study for comparing the cardiovascular outcomes of canagliflozin and other anti-diabetes drugs.

Non-SGLT2 inhibitor drugs involved in the study were dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide receptor (GLP-1) agonists or sulfonylurea drugs which were compared with canagliflozin during the study. The treatment with canagliflozin was associated with a lower risk of heart failure admission in a hospital, while compared with the other three anti-diabetic drugs. Although the risk of heart failure was reported to be low in canagliflozin treatment, the risk for stroke or myocardial infarction were found to be similar with canagliflozin as well as with other non-gliflozin or non-SGLT2 inhibitor drugs.

Type 2 Diabetes - Risk Factors - Symptoms & Signs - Management - Prevention
Globalization and changing lifestyles has made diabetes very common in developing countries so much so that India is known as the Diabetes Capital of the World.

When should you not take Canagliflozin?

Type 1 diabetes mellitus
Pregnancy and breastfeeding
Diabetic ketoacidosis
Severe kidney disease
End-stage renal disease or patients on dialysis

Coronary Heart Disease - Causes, Symptoms, Risk Factors, Diagnosis, Tretment
In coronary heart disease, blood is unable to flow through blocked arteries. The main symptom is chest pain or angina. Treatment is with medications or surgery.

What Precautions Need to be Taken while Taking Canagliflozin?

Monitor kidney functions regularly as canagliflozin affects the organ.
Ketoacidosis can be fatal, and patients should be monitored for too much acid in urine or blood, and in some cases, severe urinary tract infections can occur.
Canagliflozin can increase the chance of weakening the bones and patients should be advised to consult the physician if a sudden pain in the joints occurs.
To get the maximum benefit of canagliflozin, do not miss the dose.
Sudden decrease in blood sugar can happen especially when canagliflozin taken with other anti-diabetic drugs and patients must be educated to recognize the hypoglycemia signs
Blood sugar should be monitored regularly and do not increase or decrease the dose of canagliflozin without doctor’s approval.

Diabetic Ketoacidosis - Causes, Symptoms, Complications, Diagnosis, Treatment, Prevention
Diabetic ketoacidosis (DKA) is a dangerous complication of uncontrolled diabetes which manifests with ketones in urine along with acidosis, requires early diagnosis.