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5 results on '"Schumm-Draeger, Pm"'

1. CVOT Summit Report 2023: new cardiovascular, kidney, and metabolic outcomes.

Author

Schnell O, Barnard-Kelly K, Battelino T, Ceriello A, Larsson HE, Fernández-Fernández B, Forst T, Frias JP, Gavin JR 3rd, Giorgino F, Groop PH, Heerspink HJL, Herzig S, Hummel M, Huntley G, Ibrahim M, Itzhak B, Jacob S, Ji L, Kosiborod M, Lalic N, Macieira S, Malik RA, Mankovsky B, Marx N, Mathieu C, Müller TD, Ray K, Rodbard HW, Rossing P, Rydén L, Schumm-Draeger PM, Schwarz P, Škrha J, Snoek F, Tacke F, Taylor B, Jeppesen BT, Tesfaye S, Topsever P, Vilsbøll T, Yu X, and Standl E

Subjects
Humans, Blood Glucose Self-Monitoring, Stroke Volume, Blood Glucose, Obesity complications, Kidney, Heart Failure complications, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic therapy, Diabetes Mellitus drug therapy, Diabetes Mellitus, Type 2 drug therapy
Abstract

The 9th Cardiovascular Outcome Trial (CVOT) Summit: Congress on Cardiovascular, Kidney, and Metabolic Outcomes was held virtually on November 30-December 1, 2023. This reference congress served as a platform for in-depth discussions and exchange on recently completed outcomes trials including dapagliflozin (DAPA-MI), semaglutide (SELECT and STEP-HFpEF) and bempedoic acid (CLEAR Outcomes), and the advances they represent in reducing the risk of major adverse cardiovascular events (MACE), improving metabolic outcomes, and treating obesity-related heart failure with preserved ejection fraction (HFpEF). A broad audience of endocrinologists, diabetologists, cardiologists, nephrologists and primary care physicians participated in online discussions on guideline updates for the management of cardiovascular disease (CVD) in diabetes, heart failure (HF) and chronic kidney disease (CKD); advances in the management of type 1 diabetes (T1D) and its comorbidities; advances in the management of CKD with SGLT2 inhibitors and non-steroidal mineralocorticoid receptor antagonists (nsMRAs); and advances in the treatment of obesity with GLP-1 and dual GIP/GLP-1 receptor agonists. The association of diabetes and obesity with nonalcoholic steatohepatitis (NASH; metabolic dysfunction-associated steatohepatitis, MASH) and cancer and possible treatments for these complications were also explored. It is generally assumed that treatment of chronic diseases is equally effective for all patients. However, as discussed at the Summit, this assumption may not be true. Therefore, it is important to enroll patients from diverse racial and ethnic groups in clinical trials and to analyze patient-reported outcomes to assess treatment efficacy, and to develop innovative approaches to tailor medications to those who benefit most with minimal side effects. Other keys to a successful management of diabetes and comorbidities, including dementia, entail the use of continuous glucose monitoring (CGM) technology and the implementation of appropriate patient-physician communication strategies. The 10th Cardiovascular Outcome Trial Summit will be held virtually on December 5-6, 2024 ( http://www.cvot.org )., (© 2024. The Author(s).)

Published
2024
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2. CVOT Summit 2022 Report: new cardiovascular, kidney, and glycemic outcomes.

Author

Schnell O, Battelino T, Bergenstal R, Birkenfeld AL, Ceriello A, Cheng A, Davies M, Edelman S, Forst T, Giorgino F, Green J, Groop PH, Hadjadj S, J L Heerspink H, Hompesch M, Izthak B, Ji L, Kanumilli N, Mankovsky B, Mathieu C, Miszon M, Mustafa R, Nauck M, Pecoits-Filho R, Pettus J, Ranta K, Rodbard HW, Rossing P, Ryden L, Schumm-Draeger PM, Solomon SD, Škrha J, Topsever P, Vilsbøll T, Wilding J, and Standl E

Subjects
Humans, Blood Glucose, Blood Glucose Self-Monitoring, Glucagon-Like Peptide-1 Receptor agonists, Hypoglycemic Agents therapeutic use, Kidney, Cardiovascular Diseases diagnosis, Cardiovascular Diseases drug therapy, Cardiovascular Diseases epidemiology, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic drug therapy, Renal Insufficiency, Chronic epidemiology
Abstract

The 8th Cardiovascular Outcome Trial (CVOT) Summit on Cardiovascular, Kidney, and Glycemic Outcomes was held virtually on November 10-12, 2022. Following the tradition of previous summits, this reference congress served as a platform for in-depth discussion and exchange on recently completed outcomes trials as well as key trials important to the cardiovascular (CV) field. This year's focus was on the results of the DELIVER, EMPA-KIDNEY and SURMOUNT-1 trials and their implications for the treatment of heart failure (HF) and chronic kidney disease (CKD) with sodium-glucose cotransporter-2 (SGLT2) inhibitors and obesity with glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists. A broad audience of primary care physicians, diabetologists, endocrinologists, cardiologists, and nephrologists participated online in discussions on new consensus recommendations and guideline updates on type 2 diabetes (T2D) and CKD management, overcoming clinical inertia, glycemic markers, continuous glucose monitoring (CGM), novel insulin preparations, combination therapy, and reclassification of T2D. The impact of cardiovascular outcomes on the design of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) trials, as well as the impact of real-world evidence (RWE) studies on the confirmation of CVOT outcomes and clinical trial design, were also intensively discussed. The 9th Cardiovascular Outcome Trial Summit will be held virtually on November 23-24, 2023 ( http://www.cvot.org )., (© 2023. The Author(s).)

Published
2023
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3. Report from the CVOT Summit 2021: new cardiovascular, renal, and glycemic outcomes.

Author

Schnell O, Battelino T, Bergenstal R, Blüher M, Böhm M, Brosius F, Carr RD, Ceriello A, Forst T, Giorgino F, Guerci B, Heerspink HJL, Itzhak B, Ji L, Kosiborod M, Lalić N, Lehrke M, Marx N, Nauck M, Rodbard HW, Rosano GMC, Rossing P, Rydén L, Santilli F, Schumm-Draeger PM, Vandvik PO, Vilsbøll T, Wanner C, Wysham C, and Standl E

Subjects
Blood Glucose, COVID-19, Clinical Trials as Topic, Humans, Hypoglycemic Agents therapeutic use, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Treatment Outcome, Cardiovascular Diseases drug therapy, Diabetes Mellitus drug therapy
Abstract

The 7th Cardiovascular Outcome Trial (CVOT) Summit on Cardiovascular, Renal, and Glycemic Outcomes, was held virtually on November 18-19, 2021. Pursuing the tradition of the previous summits, this reference congress served as a platform for in-depth discussion and exchange on recently completed CVOTs. This year's focus was placed on the outcomes of EMPEROR-Preserved, FIGARO-DKD, AMPLITUDE-O, SURPASS 1-5, and STEP 1-5. Trial implications for diabetes and obesity management and the impact on new treatment algorithms were highlighted for endocrinologists, diabetologists, cardiologists, nephrologists, and general practitioners. Discussions evolved from outcome trials using SGLT2 inhibitors as therapy for heart failure, to CVOTs with nonsteroidal mineralocorticoid receptor antagonists and GLP-1 receptor agonists. Furthermore, trials for glycemic and overweight/obesity management, challenges in diabetes management in COVID-19, and novel guidelines and treatment strategies were discussed.Trial registration The 8th Cardiovascular Outcome Trial Summit will be held virtually on November 10-11, 2022 ( http://www.cvot.org )., (© 2022. The Author(s).)

Published
2022
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4. Effects of analogue insulin in multiple daily injection therapy of type 2 diabetes on postprandial glucose control and cardiac function compared to human insulin: a randomized controlled long-term study.

Author

von Bibra H, Siegmund T, Kingreen I, Riemer M, Schuster T, and Schumm-Draeger PM

Subjects
Adult, Aged, Aged, 80 and over, Biomarkers blood, Blood Glucose metabolism, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 physiopathology, Diastole, Drug Administration Schedule, Echocardiography, Doppler, Pulsed, Female, Germany, Glycated Hemoglobin metabolism, Humans, Hypoglycemic Agents adverse effects, Injections, Insulin Aspart adverse effects, Insulin Detemir adverse effects, Male, Middle Aged, Prospective Studies, Time Factors, Treatment Outcome, Blood Glucose drug effects, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents administration & dosage, Insulin Aspart administration & dosage, Insulin Detemir administration & dosage, Postprandial Period, Ventricular Function, Left drug effects
Abstract

Background: The prevention of cardiovascular disease, including diastolic cardiac dysfunction with its high prevalence and ominous prognosis, is a therapeutic challenge for patients with type 2 diabetes. Both short and long-acting insulin analogues (AI) have been shown to reduce glucose variability and provide potential benefit for cardiovascular disease although the effects on cardiac function have not yet been evaluated. This long-term, prospective, randomized controlled trial in patients with type 2 diabetes (T2D) tested the hypothesis that a multiple daily injection regimen (MDI) with AI improves postmeal glucose excursions in comparison to human insulin (HI) and that the effects of AI improve diastolic cardiac function., Methods: For 36 months, MDI treatment in 109 T2D patients was adapted every 3 months (targets: fasting glucose ≤ 110 mg/dl, postmeal glucose ≤ 150 mg/dl) in both groups: AI (insulin detemir and insulin aspart, n = 61) and HI (NPH-insulin and regular HI, n = 48). Diastolic cardiac function (myocardial velocity E' using tissue Doppler imaging and the mitral inflow ratio E/A) and vascular function were assessed before and 2 h after a standardized breakfast (48 g carbohydrates). At baseline, both groups were comparable with regards to demographic, cardiac and metabolic data. Analysis of data included traditional statistics as well as the use of a multiple imputation technique shown in brackets [ ]., Results: At 36 months, the primary endpoint, postmeal glucose, decreased by 20 ± 62 mg/dl, p = 0.038 [p = 0.021] with AI and increased insignificantly with HI (inter-group p = 0.032 [p = 0.047]) to postmeal glucose levels of 161 ± 39 with AI vs. 195 ± 54 mg/dl with HI (inter-group p = 0.002 [p = 0.010]) whereas the levels of fasting glucose and HbA1c were comparable. With AI, postmeal E' improved by 0.6 ± 1.4 cm/s, p = 0.009 [p = 0.002] and fasting E' by 0.4 ± 1.4 cm/s, p = 0.069 [p = 0.013], however, E' remained unchanged with HI. These changes were consistent with those of the traditional parameter E/A., Conclusions: MDI with AI results in better postmeal glucose control compared to HI. The treatment with AI is associated with improved diastolic cardiac function. ClinicalTrials.gov (NTC00747409).

Published
2016
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5. The role of co-morbidity in the selection of antidiabetic pharmacotherapy in type-2 diabetes.

Author

Tschöpe D, Hanefeld M, Meier JJ, Gitt AK, Halle M, Bramlage P, and Schumm-Draeger PM

Subjects
Albuminuria complications, Cardiovascular Diseases complications, Cerebrovascular Disorders complications, Diabetes Mellitus, Type 2 complications, Diabetic Retinopathy, Heart Failure complications, Hepatic Insufficiency complications, Humans, Hypoglycemia chemically induced, Hypoglycemia complications, Obesity complications, Practice Guidelines as Topic, Renal Insufficiency, Chronic complications, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use
Abstract

Metformin is, if not contraindicated and if tolerated, usually preferred over other antidiabetic drugs for the first line treatment of type-2 diabetes. The particular decision on which antidiabetic agent to use is based on variables such as efficacy, cost, potential side effects, effects on weight, comorbidities, hypoglycemia, risk, and patient preferences. However, there is no guidance how to consider these in the selection of antidiabetic drug treatment. In this work, we aimed to summarize available evidence and tried to give pragmatic treatment recommendations from a clinical practice perspective.There are clear contraindications for some drugs in those with impaired renal and liver function and precautions in those with heart failure for the use of metformin (NYHA III-IV) and glitazones. On the other hand, GLP-1 analogs, DPP-4 inhibitors and acarbose are generally less critical and can be used in the majority of patients. We identified the following gaps with respect to the selection of antidiabetic drug treatment in patients with co-morbid disease conditions: 1) Guidelines fail to give advice on the use of specific antidiabetic drugs in patients with co-morbidity. 2) The literature is deficient in studies documenting antidiabetic drug use in patients with severely impaired renal function, diabetic retinopathy, cerebrovascular disease and systolic heart failure. 3) Further there are no specific data on patients with multiple of these co-morbid disease conditions. We postulate that differential use of antidiabetic drugs in patients with co-morbid disease constellations will help to reduce treatment related complications and might improve prognosis.

Published
2013
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