Open AccessThe role of glucagon in the possible mechanism of cardiovascular mortality reduction in type 2 diabetes patients
Author(s) -
Skelin Marko,
Javor Eugen,
Lucijanić Marko,
Lucijanić Tomo,
Jakupović Lejsa,
Rahelić Dario
Publication year - 2018
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13274
Subject(s) - empagliflozin , liraglutide , medicine , type 2 diabetes , diabetes mellitus , intensive care medicine , medline , clinical trial , endocrinology , political science , law
Summary Aim Type 2 diabetes (T2D) is one of the major public health issues worldwide. The main cause of mortality and morbidity among T2D patients are cardiovascular ( CV ) causes. Various antidiabetics are used in T2D treatment, but until recently they lacked clear evidence of the reduction in CV mortality and all‐cause mortality as independent study end‐points. The aim of this article was to present and critically evaluate potential mechanisms behind the remarkable results documented in trials with new antidiabetics for the treatment of T2D. Methods Relevant data were collected using the MEDLINE , PubMed, EMBASE , Web of Science, Science Direct, and Scopus databases with the key words: “type 2 diabetes,” “mortality,” “glucagon,” “empagliflozin,” “liraglutide,” “insulin” and “ QT c.” Searches were not limited to specific publication types or study designs. Results The EMPA ‐ REG OUTCOME trial with empagliflozin and LEADER trial with liraglutide presented remarkable results regarding the reduction in mortality in T2D treatment. However, the potential mechanism for those beneficial effects is difficult to determine. It is not likely that improvements in classic CV risk factors are responsible for the observed effect. A potential mechanism may be caused by the elevation of postprandial ( PP ) glucagon concentrations that can be seen with an empagliflozin and liraglutide therapy, which could have beneficial effects considering the myocardial electrical stability in T2D patients. Conclusion This hypothesis throws new light upon possible mechanisms of reduction in mortality in T2D patients.