Choix entre une gliptine et une gliflozine chez le patient âgé avec un diabète de type 2

DPP-4 inhibitor; Elderly; Gliflozin; Gliptin; SGLT2 inhibitor; Type 2 diabetes; dipeptidyl peptidase IV inhibitor; glucose; sodium glucose cotransporter 2 inhibitor; Article; cardiovascular risk; chronic kidney failure; diabetes control; drug choice; drug safety; drug tolerability; glycemic control; human; major adverse cardiac event; non insulin dependent diabetes mellitus; risk reduction

Abstract :

[en] After failure of metformin monotherapy, both dipeptidyl peptidase-4 inhibitors (gliptins) and sodium-glucose cotransporter type 2 inhibitors (gliflozins) offer a valuable alternative to sulfonylureas, especially in older patients at risk of hypoglycemia. The choice may be guided by the different properties of the two pharmacological classes, as well as by the individual patient's characteristics. Gliptins have an excellent tolerance/safety profile, a major advantage among older fragile patients, including those with advanced renal disease. However, they do not offer other benefits besides improving glucose control. On the contrary, gliflozins target different risk factors beyond correction of hyperglycemia. Furthermore, they have proven their ability to reduce major adverse cardiovascular events, especially heart failure, as well as the progression of chronic kidney disease. However, gliflozins have a less favourable tolerance/safety profile compared to that of gliptins. Obviously, the therapy of patients with type 2 diabetes should be personalized, especially in older people. © 2021 Elsevier Masson SAS

Disciplines :

Endocrinology, metabolism & nutrition
Pharmacy, pharmacology & toxicology

Author, co-author :

Scheen, André ; Centre Hospitalier Universitaire de Liège - CHU > > Service de diabétologie, nutrition, maladies métaboliques

Language :

English

Title :

Choix entre une gliptine et une gliflozine chez le patient âgé avec un diabète de type 2

Alternative titles :

[en] Selection between a gliptin or a gliflozin for an elderly patient with type 2 diabetes

Publication date :

2022

Journal title :

Médecine des Maladies Métaboliques

ISSN :

1957-2557

eISSN :

2214-8477

Publisher :

Elsevier Masson s.r.l.

Volume :

Issue :

Pages :

264 - 270

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 24 February 2023

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Bibliography

American Diabetes Association, 9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes-2021. Diabetes Care 44:Suppl.1 (2021), S111–S124.
Darmon, P., Bauduceau, B., Bordier, L., et al. Société francophone du diabète (SFD). Prise de position de la Société francophone du diabète (SFD) sur les stratégies d'utilisation des traitements anti-hyperglycémiants dans le diabète de type 2-2021. Med Mal Metab 15 (2021), 781–801.
Scheen, A.J., Existe-t-il encore une place pour les sulfamides hypoglycémiants dans le traitement du diabète de type 2 en 2021? Les points forts du dossier des sulfamides hypoglycémiants. Med Mal Metab 15 (2021), 45–52.
Scheen, A.J., Comment je traite. A propos du positionnement des inhibiteurs de la DPP-4 (gliptines) dans le traitement du diabete de type 2. Rev Med Liege 70 (2015), 593–599.
Gallwitz, B., Clinical use of DPP-4 inhibitors. Front Endocrinol (Lausanne), 10, 2019, 389.
Bauduceau, B., Bordier, L., Bringer, J., et al. Société Francophone du Diabète (SFD). Prise de position de la Société Francophone du Diabète (SFD): évaluation du rapport bénéfices-risques des inhibiteurs de SGLT2. Med Mal Metab 13 (2019), 195–209.
Scheen, A.J., Sodium-glucose cotransporter type 2 inhibitors for the treatment of type 2 diabetes mellitus. Nat Rev Endocrinol 16 (2020), 556–577.
Scheen, A.J., SGLT2 versus DPP4 inhibitors for type 2 diabetes. Lancet Diabetes Endocrinol 1 (2013), 168–170.
Scheen, A.J., Paquot, N., Le choix entre un inhibiteur de la DPP-4 et un inhibiteur des SGLT2 pour traiter le diabète de type 2. Rev Med Liege 71 (2016), 579–585.
Scheen, A.J., Place des inhibiteurs des SGLT2 dans le traitement du patient diabétique de type 2. Med Mal Metab 12 (2018), 22–30.
Scheen, A.J., Reduction in HbA1c with SGLT2 inhibitors vs. DPP-4 inhibitors as add-ons to metformin monotherapy according to baseline HbA1c: a systematic review of randomized controlled trials. Diabetes Metab 46 (2020), 186–196.
Scheen, A.J., Efficacy/safety balance of DPP-4 inhibitors versus SGLT2 inhibitors in elderly patients with type 2 diabetes. Diabetes Metab, 47, 2021, 101275, 10.1016/j.diabet.2021.101275 [Online ahead of print].
Scheen, A.J., Careful use to minimize adverse events of oral antidiabetic medications in the elderly. Expert Opin Pharmacother 22 (2021), 2149–2165.
Scheen, A.J., Paquot, N., Bauduceau, B., Le diabète du sujet âgé: du défi épidémiologique à une approche personnalisée. Rev Med Liege 69 (2014), 323–328.
American Diabetes Association, 12. older adults: standards of medical care in diabetes-2021. Diabetes Care 44:Suppl 1 (2021), S168–S179.
Bauduceau, B., Bordier, L., Doucet, J., Diabète du sujet âgé. Vigoureux, fragile ou malade: traiter au cas par cas. Rev Prat Méd Gen 27 (2013), 859–864.
Scheen, A.J., Comment je traite. Le choix entre un sulfamide hypoglycémiant et une gliptine pour traiter le diabète de type 2. Rev Med Liege 69 (2014), 476–484.
Chen, K., Kang, D., Yu, M., et al. Direct head-to-head comparison of glycaemic durability of dipeptidyl peptidase-4 inhibitors and sulphonylureas in patients with type 2 diabetes mellitus: a meta-analysis of long-term randomized controlled trials. Diabetes Obes Metab 20 (2018), 1029–1033.
Scheen, A.J., The safety of gliptins: updated data in 2018. Expert Opin Drug Saf 17 (2018), 387–405.
Paolisso, G., Monami, M., Marfella, R., et al. Dipeptidyl peptidase-4 inhibitors in the elderly: more benefits or risks?. Adv Ther 29 (2012), 218–233.
Scheen, A.J., Paquot, N., Comment prescrire un médicament antidiabétique oral chez un patient diabétique de type 2 avec insuffisance rénale?. Rev Med Liege 72 (2017), 462–468.
Halimi, S., Stratégies et objectifs thérapeutiques du diabète de type 2: hier, aujourd'hui, demain?. Med Mal Metab 11 (2017), S32–S40.
Scheen, A.J., Études cardiovasculaires chez le patient diabétique de type 2 à risque: conclusions et impact des essais publiés en 2017-2018. Med Mal Metab 13:Suppl.1 (2019), S10–S24.
Scheen, A.J., Cardiovascular effects of new oral glucose-lowering agents: DPP-4 and SGLT-2 inhibitors. Circ Res 122 (2018), 1439–1459.
Scheen, A.J., Cardiovascular safety of DPP-4 inhibitors compared with sulphonylureas: results of randomized controlled trials and observational studies. Diabetes Metab 44 (2018), 386–392.
Scheen, A.J., Sécurité cardiovasculaire des inhibiteurs de la DPP-4 comparée à celle des sulfamides hypoglycémiants. Rev Med Suisse 14 (2018), 1468–1472.
Scheen, A.J., Paquot, N., Metabolic effects of SGLT2 inhibitors beyond increased glucosuria: a review of the clinical evidence. Diabetes Metab 40:Suppl.1 (2014), S4–S11.
Fioretto, P., Zambon, A., Rossato, M., et al. SGLT2 inhibitors and the diabetic kidney. Diabetes Care 39:Suppl.2 (2016), S165–S171.
Scheen, A.J., Effect of SGLT2 inhibitors on the sympathetic nervous system and blood pressure. Curr Cardiol Rep, 21, 2019, 70.
Scheen, A.J., Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME. Diabetes Res Clin Pract 121 (2016), 204–214.
Scheen, A.J., Delanaye, P., Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME. Diabetes Metab 43 (2017), 99–109.
Scheen, A.J., SGLT2 inhibitors: benefit/risk balance. Curr Diab Rep, 16, 2016, 92.
Scheen, A.J., An update on the safety of SGLT2 inhibitors. Expert Opin Drug Safety 18 (2019), 295–311.
Scheen, A.J., Lancellotti, P., Inhibiteurs des SGLT2: nouvelle option pour prévenir ou traiter l'insuffisance cardiaque. Rev Med Liege 76 (2021), 248–255.
Scheen, A.J., Delanaye, P., Inhibiteurs des SGLT2 chez les patients avec insuffisance rénale chronique: des essais contrôlés aux recommandations internationales et perspectives en pratique clinique. Rev Med Liege 76 (2021), 186–194.
Darmon, P., Bauduceau, B., Bordier, L., et al. Société Francophone du Diabète (SFD). Prise de position de la Société Francophone du Diabète (SFD) sur la prise en charge médicamenteuse de l'hyperglycémie du patient diabétique de type 2-2019. Med Mal Metab 13 (2019), 711–732.
Giugliano, D., Longo, M., Maiorino, M.I., et al. Efficacy of SGLT-2 inhibitors in older adults with diabetes: systematic review with meta-analysis of cardiovascular outcome trials. Diabetes Res Clin Pract, 162, 2020, 108114.
Gourdy, P., Mise au point sur le profil de tolérance de la classe des inhibiteurs de SGLT2. Med Mal Metab 13:Suppl.1 (2019), S31–S39.
Scheen, A.J., À propos de l'expérience belge avec les inhibiteurs des SGLT2. Med Mal Metab 14 (2020), 320–330.
Scheen, A.J., Delanaye, P., Acute renal injury events in diabetic patients treated with SGLT2 inhibitors: a comprehensive review with a special reference to RAAS blockers. Diabetes Metab, 48, 2022, 10315.
Scheen, A.J., Efficacy and safety profile of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease. Expert Opin Drug Safety 19 (2020), 243–256.
Scheen, A.J., Delanaye, P., Understanding the protective effects of SGLT2 inhibitors in type 2 diabetes patients with chronic kidney disease. Expert Rev Endocrinol Metab, 2021, 1–2, 10.1080/17446651.2022.2014322 (Online ahead of print).
Scheen, A.J., Paquot, N., Une révolution dans le traitement du diabète de type 2: des antidiabétiques dotés d'une protection cardio-rénale indépendamment du contrôle glycémique!. Rev Med Liege 75 (2020), 392–398.
Han, S.J., Ha, K.H., Lee, N., Kim, D.J., Effectiveness and safety of sodium-glucose co-transporter-2 inhibitors compared with dipeptidyl peptidase-4 inhibitors in older adults with type 2 diabetes: a nationwide population-based study. Diabetes Obes Metab 23 (2021), 682–691.
Scheen, A.J., DPP-4 inhibitor plus SGLT-2 inhibitor as combination therapy for type 2 diabetes: from rationale to clinical aspects. Expert Opin Drug Metab Toxicol 12 (2016), 1407–1417.
Li, D., Shi, W., Wang, T., Tang, H., SGLT2 inhibitor plus DPP-4 inhibitor as combination therapy for type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab 20 (2018), 1972–1976.
Scheen, A.J., Solutions thérapeutiques pour un patient diabétique de type 2 mal contrôlé sous une combinaison metformine plus gliptine. Med Mal Metab 13 (2019), 272–279.
Scheen, A.J., Paquot, N., Combinaison gliptine-gliflozine dans le traitement du diabète de type 2. Rev Med Suisse 12 (2016), 1384–1388.