In a study from Monash University, scientists found a common type 2 diabetes drug can reduce heart disease risk in men more than in women.
They directly compared two classes of drugs used to treat type 2 diabetes and found that one of the two classes is linked to a greater reduction of heart disease events in men than in women.
The two classes of drugs are SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1RA). Both classes of medication reduce major adverse cardiovascular events in people with T2D.
Despite women with T2D having a higher risk of developing heart disease and heart failure than men with T2D, treatment for diabetes-related heart disease remains the same across the sexes.
In the study, the team directly compare and report the sex-specific effects of SGLT2i with GLP-1RAs on major heart disease events in men and women.
They examined 8,026 Australian men and women with T2D (≥30 years), discharged from a Victorian hospital between July 1, 2013 and July 1, 2017, and dispensed an SGLT2i or GLP-1RA within 60 days of discharge.
In a follow-up period of 756 days, the team found the use of SGLT2i reduced the risk of major heart diseases events, such as heart failure and stroke, to a greater extent in men of all ages with T2D than women.
Overall, men dispensed SGLT2i had a 22% reduction rate in major adverse cardiovascular events compared to men supplied with a GLP-1RA.
But in women, there was no strong difference between SGLT2i and GLP-1RAs for their effects on major heart disease events.
The team also showed for the first time that SGLT2i, in a head-to-head comparison GLP-1RAs, reduces major heart disease rates in both older men and women (≥65 years) with T2D, in men with a history of heart failure, and in women with artery stiffness disease.
The team says the apparent disparity between the relative benefits of SGLT2i versus GLP-1RAs in T2D men and women warrants further testing.
The team says there may be a number of reasons women with T2D are more at risk of developing cardiovascular disease and heart failure than men with T2D.
Typically women with T2D present with greater insulin resistance, blood vessel dysfunction, inflammation, belly fat, obesity, and blood sugar and cholesterol levels than men with T2D.
Additionally, increases in heart disease and heart failure risk in older women suggest an integral role of estrogen in cardioprotection in women.
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The study was conducted by Abhipree Sharma et al and published in The Lancet Regional Health—Western Pacific.
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