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Mineralocorticoid Receptor Antagonists in Heart Failure with Preserved Ejection Fraction: The TOPCAT and ALDO-DHF trials
There are approximately 500,000 Canadians living with heart failure, and more than 10% in patients older than 65. Up to 50% of patients presenting with signs and symptoms of heart failure will have a preserved ejection fraction (HFpEF or diastolic dysfunction). However, there is a lack of evidence for effective therapies in the management of HFpEF.
Incretin Safety: What is the Evidence?
Nausea can be a common side effect of GLP-1 receptor agonist, which can sometimes be dose limiting. However, this usually improves with time. As a new class of agents, evidence for the long-term safety of incretins is still emerging. Most of the safety questions involve cardiovascular (CV) risk, as well as pancreatitis and pancreatic cancer.
Diabetes and exercise
I direct more effort to encouraging physical activity as a critical tool in the management of T2D. I emphasize a healthy diet but stress that weight loss is not the primary goal, exercise is.
Tailoring therapy for type 2 diabetes: the role of incretins
These oral agents, administered once daily, augment endogenous GLP-1, resulting in an A1C reduction of 0.5 – 0.9%. Since GLP-1 does not directly stimulate insulin, they have the advantage of not promoting hypoglycemia or weight gain.
This app changed my practice: Pocket A1C
In response to reader requests and the increasing interest in mobile apps, we are launching a series of articles highlighting useful iPhone apps. These will appear approximately once every three months.
New targets for Diabetes (A1C): Why we are aiming at 'only' 7 percent
Recent studies suggest that the relationship between glucose control (A1C) and cardiovascular disease is more complex than we may have realized.
New study on the use of erythropoietin stimulating agents in chronic kidney disease has made us evaluate the risk-benefit of ESA’s in CKD patients not on dialysis.
The evidence strongly suggests that there is little to no benefit gained by raising the Hb over > 100g/L (and perhaps even lower) in diabetic patients with CKD not on dialysis.
What are the CV risks of TZDs: have the safety questions been answered?
Since their introduction, certain contraindications and side effects have been well known, including worsening heart failure, edema (including macular edema) and weight gain.
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