T2DM: Trials

Question 1

UKPDS34 trial

Answer 1

Metformins benefit on CVD + mortality in T2DM

Question 2

Empa-reg study

Answer 2

looked at empagliflozin + CVD (2nd prevention )

—- decrease risk of death, stroke , or MI
—- decrease hospital due to HF

Question 3

Canvas trial

Answer 3

canagliflozin + CVD/high risk CVD
— showed CV protection (decrease death due to CV, stroke or MI
— no difference on stopping death by CV reasons specifically; mainly helped with prevention of MI

Question 4

Declare-TIMI 58

Answer 4

dapagliflozin + CVD
- provided some CV protection (against CV death or hospital due to HF

• no protection against MACE

Question 5

Credence trial

Answer 5

T2DM + CKD + C
- helped decrease risk of KF or CV death
- 2nd protection

Question 6

DAPA CKD trial

Answer 6

CKD +/- T2DM + dapa
—- helped reduce risk of decline in eGFR, ESRD or CV death

• 2nd prevention

Question 7

EMPA-kidney

Answer 7

showed that empag is renally protective as 2nd prevention (already have CKD)

Question 8

DAPA-HF

Answer 8

dapa is good for 2nd prevention of HF (worsening) in t2DM

Question 9

EMPEROR-reduced + EMPERor-preserved

Answer 9

emp good for 2nd prevention in HF

Question 10

Rewind trial

Answer 10

dulaglutide —- CV protection
- unclear if primary or secondary

Question 11

Leader trial

Answer 11

liraglutide —- CV protection

Question 12

Sustain-6 trial + Pioneer 6

Answer 12

semaglutide —- CV protection (SC)

pioneer-6: CR protection (oral)

Question 13

Soul study

Answer 13

oral semaglutide —- CV outcomes
- decrease risk of MACE

— as CV protection against events

Question 14

Surpass-2 trial

Answer 14

Tirzepatide has more glucose lowering effects + weight loss than ozempic 1mg weekly
— lower A12 by 2%
— weight loss 7-11kg (compared to 5)

Question 15

Savor-timi 53 trial

Answer 15

saxagliptin — increase rate of HF hospital

Question 16

Tecos

Answer 16

sitagliptin + no impact on CV

Question 17

Examine

Answer 17

alogliptin + no impact on CV

Question 18

Carmelina

Answer 18

lingaliptin + no impact on CV

Question 19

PROActive trial

Answer 19

pioglitazone —-increase risk of HF (new or worsening)

Question 20

Record

Answer 20

Rosiglitatzone —- increase of MI

Question 21

UKPDS 33

Answer 21

T2DM — looked at 1st gen
- less micro outcomes, no impact on CV

Question 22

ACE trial

Answer 22

acarbose + cardiovascular evaluation
- no benefit

Question 23

Treat to target in T2DM (4-T) trial

Answer 23

better control with addition of basal insulin compared to adding biphasic insulin
- similar glycemic control , less weight gain + hypo risk

Question 24

Devote trial

Answer 24

compared degludec vs glargine U100
— no differences on CV effect
- less severe hypos with D

Question 25

What onward trials study which groups

Answer 25

New insulin starting in T2DM: onwards 1,3,5 T2DM on previous insulin: onwards 4+6 T1DM on previous insulin: 6

Question 26

What did the onwards studies show

Answer 26

showed that icodec has just as good of glucose control as basal (maybe even better) —- increased risk of severe hypos in T1DM

Question 27

DCCT

Answer 27

T1DM: looked at controlling A1c

Question 28

UPKDS38

Answer 28

Tight BP control over long time — prevent retinopathy

Question 29

ACCORD EYE

Answer 29

fenofibrate+ simvastatin + good glycemic control helps—- reduce progression of retinopathy

Question 30

EDIC trial

Answer 30

intensive Basal/bolus therapy (T1DM) can help reduce risk of CKD in T1DM

Question 31

ADVANCE trial

Answer 31

good A1C control

Question 32

HPS

Answer 32

showed simvastatin decrease CI + CVD risk in people with DM

Question 33

CARDS

Answer 33

- look at atorvastatin + its ability to prevent CVD/ CVE (primary prevention of people getting or having CVEs) —-helped outline criteria for when we give statins

Question 34

UKPDS

Answer 34

showed decrease in macrovascular events with tight BP control

Question 35

HOT trial

Answer 35

why we target diastolic BP of < 80 - showed huge benefit on decrease CVEs