Old and Novel Therapeutic Approaches in the Management of Hyperglycemia, an Important Risk Factor for Atherosclerosis.
Study Goal
The researchers aimed to review the role of vitamin D (and indirectly calcium equilibrium) in managing glucose levels and cardiovascular risk in patients with type 2 diabetes mellitus (T2DM).
Results Summary
The abstract highlights that vitamin D deficiency is common in T2DM patients and may worsen cardiac dysfunction, while SGLT2 inhibitors might further reduce vitamin D levels, increasing fracture risk. Vitamin D's anti-inflammatory and calcium-regulating effects are noted as beneficial but require further consideration.
Population
Patients with type 2 diabetes mellitus (T2DM) and insulin resistance, particularly those with vitamin D deficiency.
Effective Dosage
Not specified
Duration
Not specified
Interactions
SGLT2 inhibitors may adversely affect vitamin D production.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
high glucose levels | increase | multiple pathological processes, such as oxidative stress and hyperproduction of pro-inflammatory mediators, leading to endothelial dysfunction | - | - | trigger | #1 |
glucagon-like-peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) | decrease | glucose concentration and cardiovascular risk | - | - | could be considered a powerful tool for to reduce | #2 |
type 2 diabetes mellitus (T2DM) and insulin resistance | decrease | vitamin D | many patients | - | have been found to be deficient in | #3 |
T2DM and vitamin D deficiency | increase | cardiac dysfunction | patients | - | unfavorable prognostic values | #4 |
SGLT2i | decrease | production of vitamin D | - | - | could adversely affect | #5 |
SGLT2i | increase | risk of fractures | patients with T2DM | - | increasing | #6 |
vitamin D | neutral | anti-inflammatory mediator and a regulator of endothelial function and calcium equilibrium | - | - | biological effects as | #7 |
antidiabetic and antiplatelet drugs coupled with vitamin D supplementation | decrease | glucose levels | - | - | to control | #8 |
antidiabetic and antiplatelet drugs coupled with vitamin D supplementation | decrease | risk of coronary artery disease (CAD) | - | - | reducing | #9 |
Hyperglycemia is considered one of the main risk factors for atherosclerosis, since high glucose levels trigger multiple pathological processes, such as oxidative stress and hyperproduction of pro-inflammatory mediators, leading to endothelial dysfunction. In this context, recently approved drugs, such as glucagon-like-peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), could be considered a powerful tool for to reduce glucose concentration and cardiovascular risk. Interestingly, many patients with type 2 diabetes mellitus (T2DM) and insulin resistance have been found to be deficient in vitamin D. Recent studies pointed out the unfavorable prognostic values of T2DM and vitamin D deficiency in patients with cardiac dysfunction, either when considered individually or together, which shed light on the role of vitamin D in general health status. New evidence suggests that SGLT2i could adversely affect the production of vitamin D, thereby increasing the risk of fractures, which are common in patients with T2DM. Therefore, given the biological effects of vitamin D as an anti-inflammatory mediator and a regulator of endothelial function and calcium equilibrium, these new findings should be taken into consideration as well. The aim of this review is to gather the latest advancements regarding the use of antidiabetic and antiplatelet drugs coupled with vitamin D supplementation to control glucose levels, therefore reducing the risk of coronary artery disease (CAD).