T4 PPTs

Question 1

What are CVOTs?

Answer 1

Cardiovascular Outcomes Trials, designed to assess the cardiovascular safety of diabetes medications.

Question 2

What led to the FDA’s requirement for CVOTs in diabetes medications?

Answer 2

A study showing possible increased cardiovascular risk with rosiglitazone.

Question 3

What are the key components measured in CVOTs?

Answer 3

MACE (Major Adverse Cardiac Events) including cardiovascular death, non-fatal MI, non-fatal stroke.

Question 4

What was the result of the EMPA-REG Outcomes Trial?

Answer 4

Empagliflozin reduced cardiovascular death by 38% and MACE by 14%.

Question 5

What did the CANVAS trial show regarding canagliflozin?

Answer 5

It reduced MACE by 14% and cardiovascular death by 13%.

Question 6

How do SGLT2 inhibitors impact heart failure?

Answer 6

They significantly reduce the risk of hospitalization for heart failure.

Question 7

What is the significance of the LEADER trial?

Answer 7

Liraglutide reduced cardiovascular events by 13% and MACE by 22%.

Question 8

Which medications showed renal benefits in CVOTs?

Answer 8

SGLT2 inhibitors like empagliflozin and GLP-1 receptor agonists like liraglutide.

Question 9

What is the FDA indication for canagliflozin in patients with CKD?

Answer 9

To reduce the risk of ESRD in adults with T2DM and diabetic nephropathy.

Question 10

Which CVOT showed benefits in heart failure with or without diabetes?

Answer 10

Dapagliflozin in the DAPA-HF trial.

Question 11

What is the definition of chronic kidney disease (CKD)?

Answer 11

Kidney damage determined by elevated urinary albumin or low eGFR.

Question 12

What is the leading cause of end-stage renal disease (ESRD)?

Answer 12

Diabetes and hypertension.

Question 13

What percentage of patients with diabetes develop CKD?

Answer 13

20-40% of patients with diabetes.

Question 14

What is albuminuria?

Answer 14

Urinary albumin-to-creatinine ratio >30 mg/g.

Question 15

What is considered abnormal eGFR in CKD?

Answer 15

eGFR <60 mL/min/1.73 m².

Question 16

How does CKD impact pharmacologic management in diabetes?

Answer 16

CKD progression influences the choice and dose of diabetes medications.

Question 17

What is the first-line treatment for CKD in patients with diabetes?

Answer 17

SGLT2 inhibitors to reduce the risk of CKD progression.

Question 18

How is CKD progression measured?

Answer 18

By tracking eGFR and urinary albumin levels.

Question 19

What is the importance of SGLT2 inhibitors in CKD management?

Answer 19

They slow the progression of CKD and reduce cardiovascular risk.

Question 20

What medications should be avoided in patients with advanced CKD?

Answer 20

Metformin and NSAIDs due to the risk of lactic acidosis and kidney damage.

Question 21

What is ASCVD?

Answer 21

Atherosclerotic cardiovascular disease, a major complication of diabetes.

Question 22

What are common conditions coexisting with diabetes that increase ASCVD risk?

Answer 22

Hypertension, dyslipidemia, and obesity.

Question 23

How does diabetes itself impact cardiovascular risk?

Answer 23

It independently increases the risk of ASCVD.

Question 24

What are the key CV risk factors for patients with diabetes?

Answer 24

Hypertension, smoking, dyslipidemia, obesity, and CKD.

Question 25

What are the ADA indicators of high CV risk?

Answer 25

Age >55 with two or more risk factors like hypertension, dyslipidemia, or albuminuria.

Question 26

What is the recommended treatment for patients with ASCVD and diabetes?

Answer 26

SGLT2 inhibitors or GLP-1 receptor agonists with cardiovascular benefits.

Question 27

What is the impact of GLP-1 receptor agonists on cardiovascular risk?

Answer 27

They reduce major adverse cardiovascular events (MACE) and lower blood pressure.

Question 28

Why is early detection of ASCVD important in diabetes management?

Answer 28

It helps guide pharmacologic therapy and improves long-term outcomes.

Question 29

What is the primary goal of pharmacologic therapy in patients with ASCVD?

Answer 29

To reduce cardiovascular risk while managing glycemic control.

Question 30

Which medications have demonstrated the greatest cardiovascular benefits in CVOTs?

Answer 30

SGLT2 inhibitors and GLP-1 receptor agonists.

Question 31

What is the role of MACE in CVOTs?

Answer 31

It measures the composite of cardiovascular death, non-fatal MI, and non-fatal stroke.

Question 32

Which drug class was first to show a reduction in both cardiovascular and renal outcomes in CVOTs?

Answer 32

SGLT2 inhibitors.

Question 33

What is the role of GLP-1 receptor agonists in reducing stroke risk?

Answer 33

They lower the risk of ischemic stroke in patients with diabetes and ASCVD.

Question 34

How does dapagliflozin benefit patients with heart failure?

Answer 34

It reduces hospitalization for heart failure in patients with or without diabetes.

Question 35

Which CVOT focused on renal disease as the primary endpoint?

Answer 35

The CREDENCE trial with canagliflozin.

Question 36

What are the two primary types of cardiovascular events measured in CVOTs?

Answer 36

Cardiovascular death and non-fatal myocardial infarction.

Question 37

Why was the EMPA-REG Outcomes Trial significant?

Answer 37

It was the first trial to show cardiovascular and renal benefits for empagliflozin.

Question 38

What are the FDA-approved indications for empagliflozin?

Answer 38

To reduce the risk of cardiovascular death and hospitalization for heart failure.

Question 39

What is the impact of liraglutide on cardiovascular risk?

Answer 39

It reduces the risk of major cardiovascular events by 22% in the LEADER trial.

Question 40

How does GLP-1 receptor agonist therapy impact renal outcomes?

Answer 40

It reduces the risk of new or worsening nephropathy in patients with diabetes.