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Can Certain Type 2 Diabetes Medicines Protect Your Heart?

Can Certain Type 2 Diabetes Medicines Protect Your Heart?

Learn how some type 2 diabetes medications may help protect your heart from cardiovascular disease.

People with type 2 diabetes are at a much higher risk of numerous forms of cardiovascular disease, including coronary artery disease, peripheral artery disease, cardiomyopathy, heart attacks and stroke. When heart disease occurs alongside diabetes, or because of diabetes, it is sometimes called diabetic heart disease.

If you have type 2 diabetes, keeping your blood glucose levels at goal is an important step to protecting yourself from cardiovascular disease, as well as other diabetes complications, like chronic kidney disease and diabetic neuropathy. It is also important to monitor and manage other risk factors such as cholesterol levels, blood pressure and excess body weight.

In addition to making lifestyle changes—such as exercising, eating a healthy diet and giving up unhealthy habits like smoking—your healthcare provider (HCP) may prescribe a medication to help you manage type 2 diabetes and get your numbers to goal. Some diabetes drugs may have the added benefit of protecting your heart from the effects of cardiovascular disease.

Metformin
Metformin is an oral medication that is typically the first-line drug prescribed for someone who has been diagnosed with type 2 diabetes. It’s a popular choice among HCPs and patients because it is effective and has a low risk of side effects. It is also inexpensive.

Metformin works by decreasing the amount of glucose made in the liver, lowering the amount of glucose absorbed in the gut and increasing the body’s sensitivity to insulin. Metformin can be taken as a stand-alone medication or may be prescribed to use in combination with other diabetes drugs.

Research suggests that taking metformin for type 2 diabetes may lower a person’s risk of dying from any cause. Researchers have also started to investigate the possibility of using metformin as a treatment for cardiovascular disease in people who do not have type 2 diabetes, but there is currently no conclusive opinion, and metformin is only approved for treating diabetes.

Diabetes drugs for people with cardiovascular disease
There are two other classes of diabetes medications available. Some of these medications are approved by the U.S. Food and Drug Administration specifically for people with type 2 diabetes who have cardiovascular disease. The first drugs approved in each class are:

  • Empagliflozin: This medication is part of a category of drugs called sodium-glucose co-transporter-2 inhibitors, or SGLT2 inhibitors, which prevent the kidneys from absorbing glucose so that excess glucose can be expelled in urine. It is taken orally, once a day, and can be used on its own or in combination with other medications. It is indicated to reduce the risk of dying from cardiovascular disease in patients with type 2 diabetes. Because it affects kidney function, it is not an appropriate choice for patients with kidney disease.
  • Liraglutide: This medication is given by injection and is a glucagonlike peptide 1 receptor agonist (GLP-1 RA), a type of medication that helps the pancreas make more insulin, prevents the liver from making too much glucose and slows gastric emptying. It is usually taken in combination with other diabetes medications. It is indicated to reduce the risk of heart attacks, stroke and death from cardiovascular disease.

Both of these medications are also approved for treating type 2 diabetes in patients who do not have cardiovascular disease. Researchers are continuing to look for new ways to help treat cardiovascular disease in people with diabetes.

Work with your HCP
Remember, there is no cure for type 2 diabetes and not every diabetes medication is right for every person. No one thing will control your blood glucose levels or protect your heart from cardiovascular disease. Keeping diabetes under control and your heart healthy requires numerous steps.

So, work on living a healthy lifestyle that includes eating the right foods and exercising. Take your medications as directed by your HCP. Meet with your HCP regularly to evaluate how well your treatment plan is working, and what adjustments or additional steps you can take to keep your numbers at goal and protect yourself from diabetes complications.

Medically reviewed in December 2019. Updated in August 2020.

Sources:

American Heart Association. “Cardiovascular Disease and Diabetes.”
H Ritchie & E Dale Abel. “Basic Mechanisms of Diabetic Heart Disease.” Circulation Research. May 21, 2020. 126:1501–1525.
ME Hölscher, C Bode, & H Bugger. “Diabetic Cardiomyopathy: Does the Type of Diabetes Matter?” International Journal of Molecular Sciences. December 17, 2016. 17(12), 2136.
National Heart, Lung, and Blood Institute. “Coronary Heart Disease.”
American Diabetes Association. “Complications.”
National Kidney Foundation. “Diabetes and Chronic Kidney Disease.”
National Institute of Diabetes and Digestive and Kidney Diseases. “What Is Diabetic Neuropathy?”
Debabrata Mukherjee, MD, FACC. “Cardiovascular Importance of New Diabetes Drugs.” American College of Cardiology. May 22, 2017.
Johns Hopkins Medicine. “Diabetes Drug, Metformin, Lowers Risk of Heart Disease Deaths Better Than Sulfonylureas, New Analysis Shows.” April 18, 2016.
University of California San Francisco. “Metformin.”
R Song. “Mechanism of Metformin: A Tale of Two Sites.” Diabetes Care. 2016 Feb; 39(2): 187-189.
Science Daily. “Diabetes drug, metformin, lowers risk of heart disease deaths better than sulfonylureas.” April 19, 2016.
FS Yen, W Chen, et al. “Effects of metformin use on total mortality in patients with type 2 diabetes and chronic obstructive pulmonary disease: A matched-subject design.” PloS One. 13(10), e0204859. October 4, 2018.
American College of Cardiology. “Metformin Use and CV Outcomes Among Diabetes Patients.” August 2, 2019.
Diabetes in Control. “Metformin Lowers Risk of Heart Disease and Mortality.” August 10, 2012.
G Rena & CC Lang. “Repurposing Metformin for Cardiovascular Disease.” Circulation. 2018;137:422–424.
U.S. Food & Drug Administration. “FDA Drug Safety Communication: FDA revises warnings regarding use of the diabetes medicine metformin in certain patients with reduced kidney function.”
Allison Tsai. “New Combo Drugs Control Diabetes.” Diabetes Forecast. March 2015.
Kathleen Doheny. “FDA Approves Jardiance to Treat Cardiovascular Disease in Diabetes Patients.” Endocrine Web. January 30, 2017.
O Sizar, V Podder, R Talati. “Empagliflozin.” StatPearls Publishing. Updated June 6, 2020.
Johns Hopkins Medicine. “Diabetes Medications That Treat Heart Disease, Too.”
Harvard Health Publishing. “Deterring heart disease if you have diabetes.” February 2018.
S Yandrapalli & WS Aronow. “Cardiovascular benefits of the newer medications for treating type 2 diabetes mellitus.” Journal of Thoracic Disease. 9(7), 2124–2134.
Kristine Fiore. “Another Diabetes Drug Scores Heart Indication.”Medpage Today. August 25, 2017.
Ana Sandoiu. “Diabetes drug found to reduce heart and kidney disease risk.” Medical News Today. June 13, 2017.

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