The case for why SGLT2is or GLP-1 receptor agonists should be initiated early in diabetes treatment, regardless of whether the patient is on insulin therapy. Researchers analyzed 8 different studies for 3 differing classes of diabetes medications for results. Upon completing this analysis, researchers determined that patients who used insulin in conjunction with other diabetes drugs were at a greater risk of having an adverse cardiovascular event than those taking diabetes medications without insulin. Even with the outcome of the results, it is still advised that SGLT2 inhibitors and GLP-1 receptor agonists be prescribed as soon as possible to reap the most heart benefits from them. Major adverse cardiovascular events were assessed by researchers from multiple trials for cardiovascular outcomes. The drugs used in these trials were DPP-IV inhibitors, SGLT2 inhibitors, and GLP-1 receptor MedicGLP Capsules agonists. Researchers between two groups of patients made comparisons. The first group of patients was prescribed insulin at baseline before starting any other medications.

The second group of patients has been prescribed insulin at baseline. In addition to the two groups mentioned above, two different placebo groups were given a placebo in place of drug therapy. Upon comparison, results showed that patients receiving drug therapy with no baseline insulin saw greater cardiovascular benefits than those who received placebo with no insulin. Patients who were given the drug regimen while on baseline insulin also saw significant cardiovascular benefits. Patients in both groups receiving baseline insulin experienced adverse cardiovascular effects. From these study results, one can gather that diabetes patients should all be on an SGLT2 inhibitor or GLP-1 receptor agonist regardless of whether they are on insulin therapy. Although the studies showed that patients on insulin and other drug therapy had adverse cardiovascular events, there is still a more significant cardiovascular benefit than insulin alone. In cases like these, the physician must weigh the risk versus the benefits.

For example, suppose a patient with diabetes, who is on insulin, went to their doctor with no other risk factors for Medic GLP developing cardiovascular disease. In that case, the doctor MedicGLP may be justified in not prescribing an SGLT2 inhibitor or GLP-1 receptor agonist. On the other hand, suppose a similar patient shows up but has risk factors for cardiovascular disease. In that case, the doctor might want to prescribe them one of the two drug classes to help decrease their risks of having a cardiovascular event. Patients see a more significant benefit when prescribed an SGLT2 (sodium-glucose co-transporter-2) inhibitor or Medic GLP-1 (glucagon-like peptide 1) receptor agonist during cardiovascular issues. Although patients on baseline insulin are at higher risks of experiencing adverse cardiovascular events, adding an SGLT2 inhibitor or GLP-1 receptor agonist is still beneficial for their heart health. Physicians should weigh the risks versus the benefits when considering prescribing SGLT2 inhibitors and GLP-1 receptor agonists to patients who are already on baseline insulin. Regina Schaffer, Prescribe SGLT2 inhibitors, GLP-1 receptor agonists ‘as early as possible’ for CV benefit. Joanna E Khatib, Yixue Shao, The Association Between Baseline Insulin Treatment and Cardiovascular Events: A Meta-Analysis.

Science continues to prove that the old adage "you are what you eat" is profoundly true. This is because you have trillions of microorganisms living in your gut, which are directly responsible for nearly every aspect of your health. These microbes make up what’s called your "gut microbiota." They are especially influential in determining your likelihood of gaining excessive weight, becoming obese, and developing obesity-related diseases like diabetes, heart disease, and premature death. The gut microbiome (the expressed genes of your gut microbiota) plays a major role in your metabolism through energy production, storage, and expenditure. So, it’s no surprise that science has found a strong connection between gut microbiome imbalance and metabolic syndrome. Yikes! If you have the wrong mix of microbes, it could be making it tough for you to get your health on track! Did you know: Scientists can actually look at your gut microbiome composition and tell with 90% accuracy if you are obese or lean. That’s pretty impressive, isn’t it?