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Type 2 diabetes: the combination of diabetes medications that help minimize heart failure

Metformin is used with a healthy diet and exercise and is the first drug of choice to start treating prediabetes or type 2 diabetes. But metformin alone is not always suitable. A series of studies on what other drugs to add to control high blood sugar are giving consistent results on which drugs will lower blood sugar with the lowest risk of heart failure.

In February 2019, the online magazine Plus one reported on research from the Yonsei University School of Medicine in Seoul, Korea, and the Ajou University School of Medicine in Suwon, Korea, comparing three families of antidiabetic drugs that had been added to metformin in treatment of people with type 2 diabetes. The researchers compared 42,683 people with diabetes who received sulfonylureas …

  • 50,310 participants received dipeptidyl peptidase-4 (DPP-4i) inhibitors, and

  • 5,390 participants took thiazolidinediones in addition to metformin.

People with type 2 diabetes who received dipeptidyl peptidase-4 inhibitors had the lowest rate of heart failure. The researchers concluded that adding dipeptidyl peptidase-4 inhibitors to metformin resulted in a lower risk of heart failure than adding either of the other two types of drugs.

A list of DPP-4i includes …

  • Januvia (sitagliptin),

  • Galvus (vildagliptin),

  • Onglyza (saxagliptin) and

  • Tradjenta (linagliptin).

Medicines work by increasing the amount of sugar released by the kidneys into the urine. People with type 2 diabetes should be alert to the risk of developing a genital / urinary tract infection from this exposure to sugar. Some people with diabetes have experienced gangrene near the genital organs.

Signs and symptoms of urinary tract infection include …

  • burning when urinating

  • frequent or severe need to urinate, even when there is little urine

  • pain or pressure sensation in the lower abdomen or back

  • cloudy, dark, red, or strange-smelling urine

  • tiredness or tremors, and

  • fever or chills (indicating that the infection may affect the kidneys).

Type 2 diabetics are susceptible to urinary tract infections due to incomplete emptying of the bladder. Urinary tract infections are treated with antibiotics and usually resolve in about 10 days.

The signs and symptoms of Fournier’s gangrene are …

  • pain or swelling of the genitals or anal area

  • a foul odor from the affected tissue,

  • crackle when an area is touched,

  • dehydration,

  • a dry tongue,

  • either no urination or dark urine,

  • dizziness,

  • a fast heartbeat, or

  • difficulty breathing,

  • Dry Skin,

  • dizziness,

  • a fast heartbeat

  • fast breathing,

  • Hollow eyes,

  • drowsiness,

  • tiredness,

  • confusion,

  • irritability and

  • Fainting.

People with type 2 diabetes can be susceptible to gangrene due to poor circulation. Fournier’s gangrene is treated with surgical removal of dead tissue and intravenous antibiotics. If treated promptly, the condition has a good prognosis, but it should not be allowed to spread into the blood.

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