These diabetes medicines also work against heart failure – Naturopathy & Naturopathic Treatment Portal

Diabetes medication for heart failure

According to experts, more and more people in Germany suffer from heart failure. According to the current state of medicine, the disease is not yet curable, but it is well treatable. The treatment is intended to slow down the progression of the disease and improve the symptoms so that an active life remains possible. It is now reported that two drugs that have been developed for the treatment of diabetes are also effective against heart failure.

The chronic one Heart failure, also known as heart failure, is one of the most common diseases in Western countries. In Germany alone, the number of those affected is estimated at two to three million. Their quality of life is often extremely limited. If left untreated, the disease can be fatal. But now there is reason for hope: in scientific studies, the effectiveness of two drugs that were actually developed for the treatment of diabetes has been proven against heart failure.

High mortality

Like the German Society for Cardiology – Heart and Circulatory Research eV (DGK) in one Message explains, chronic heart failure usually develops as a result of other cardiovascular diseases such as high blood pressure, coronary heart disease (CHD) and especially after heart attacks or myocarditis. In addition, some forms of heart muscle disease (genetic cardiomyopathies) have a genetic predisposition.

Although efficient drugs for treating heart failure and, above all, the underlying diseases have been developed in recent years, mortality and hospital admissions have remained high.

New study data are now drawing the attention of cardiologists to the drugs dapagliflozin and empagliflozin from the group of SGLT 2 inhibitors originally developed for diabetes mellitus.

After some oral diabetes drugs caused increases in hospital admissions because of worsening heart failure in the past, the US Food and Drug Administration (FDA) made safety studies mandatory for all newly developed anti-diabetic drugs. According to the DGK, approval studies on SGLT2 inhibitors showed that they not only help with diabetes, but also seem to improve heart failure.

Decrease in the risk of death

According to the experts, the class of SGLT2 inhibitors inhibits the reuptake of glucose from the so-called primary urine back into the blood. This then leads to a loss of glucose and thus to a lowering of blood sugar.

However, the substances not only lead to a loss of glucose via the kidneys, but also to a loss of sodium and metabolic changes that could be energetically beneficial for the heart.

The effect of the two drugs on heart failure has now been examined in two large studies: The results of the DAPA-HF– and the EMPEROR-Study published in The New England Journal of Medicine.

These were large, multicenter studies with a total of more than 8,000 patients, who were treated double-blind and randomized. Interestingly, heart failure patients with impaired ventricular function with and without diabetes were included.

All study participants continued to receive optimal standard therapy for cardiac insufficiency. Both studies consistently showed a decrease in the risk of cardiovascular death and heart failure hospital admissions of about 25 percent. The effects in both studies were independent of modern concomitant therapy and were comparable in patients with and without diabetes mellitus.

The kidney function is also improved

“The consistent decrease in heart failure complications in diabetics and non-diabetics in the studies is impressive,” says Prof. Dr. Michael Böhm, press spokesman for the DGK and scientific director of both studies for Germany. “This shows that an efficient heart failure drug can evolve from a diabetes drug, as evidenced by its effectiveness in non-diabetics.”

DGK President Prof. Dr. Andreas Zeiher adds: “These study results are really good news for all patients with cardiac insufficiency. So far, no other drug has shown such convincing results, especially because the kidney function is significantly improved at the same time. “

Böhm’s conclusion is that the SGLT2 inhibitors will most likely be included with a strong recommendation in the European guidelines for the diagnosis and treatment of heart failure, which will appear in 2021. This guideline is currently being prepared by an international committee of experts. (ad)

Author and source information

This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.

Swell:

  • German Society for Cardiology – Heart and Circulatory Research eV (DGK): With diabetes drugs against heart failure, (accessed: 22.09.2020), German Society for Cardiology – Heart and Circulatory Research eV (DGK)
  • Milton Packer, M.D., Stefan D. Anker, M.D., Ph.D., Javed Butler, M.D., Gerasimos Filippatos, M.D., Stuart J. Pocock, Ph.D., Peter Carson, M.D., James Januzzi, M.D., Subodh Verma, M.D., Ph.D., Hiroyuki Tsutsui, M.D., Martina Brueckmann, M.D., Waheed Jamal, M.D., Karen Kimura, Ph.D., et al.: Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure; in: The New England Journal of Medicine, (veröffentlicht: 29.08.2020), The New England Journal of Medicine
  • John J.V. McMurray et al.: Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction; in: The New England Journal of Medicine, (veröffentlicht: 05.03.2020), The New England Journal of Medicine

Important NOTE:
This article is for general guidance only and should not be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.

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Why does Peru have the highest mortality in the world from COVID-19?

Low investment in health for decades, a fragmented health system with a shortage of doctors and beds, widespread informality, and a largely obese and rebellious population have come together in a “perfect storm” that makes Peru the country with the highest relative mortality in the world from COVID-19.

With more than 29,000 deaths from the coronavirus, Peru registers 88 deaths per 100,000 inhabitants, the highest rate globally, and is the fifth country in the world and the second in Latin America in confirmed cases, accumulating more than 652,000 infections.

See also: Peru proposes to retire with only 10 years of contributions due to crisis due to COVID-19

1. Low investment in health

Before the outbreak of the coronavirus, Peru had budgeted to spend in 2020 about 18,500 million soles (about 5,240 million dollars) on health, 2.2% of its gross domestic product, one of the lowest rates in Latin America.

Peru’s public spending on health has been far from the 6% of GDP that the World Health Organization recommends investing in this sector for decades, and far from the 10.1% average of the OECD countries.

Instruments for even the simplest procedures are common in public hospitals.

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2. Fragmented health system

Peruvian public health operates under a chaotic fragmentation, divided into two large entities and other smaller ones with their own networks of hospitals and medical centers that, until the arrival of the pandemic, acted in parallel and without being related. To make it even more diverse, the regions also have competencies in health.

3. Few doctors and few ICU beds

Before the pandemic, Peru had a historical deficit of 24,000 doctors, according to former Minister of Health Víctor Zamora. There was some 13 doctors for every 10,000 inhabitants.

At the beginning there were only 900 ICU beds (2.9 per 100,000 inhabitants), again among the lowest ranges in the region, according to the OECD Health Outlook 2020. Only 276 were available for COVID-19. Now they have increased to more than 1,500 ICU beds.

4. Rebellion of the population

The population has also not collaborated to prevent the collapse of the public health system by skipping almost from the beginning the strict quarantine imposed in mid-March by the Government.

More than 50,000 people were detained during the first two months of the emergency for disrespecting quarantine and night curfews.

See also: Thirteen dead and six injured by human avalanche at clandestine party in Peru

5. Widespread informality

70% of the economically active population in Peru works informally, without paying taxes and many without health insurance, which takes away resources from the State to be able to provide more comprehensive health coverage.

6. Obesity

The Ministry of Health reported that 85% of those killed by COVID-19 were obese, 43% diabetic, and 27% hypertensive, three of the main factors that exacerbate coronavirus symptoms.

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Unicef: Italy 19th out of 38 countries for child welfare – Chronicle

In the new UNICEF report on child well-being in rich countries, the Netherlands, Denmark and Norway have the best results, while Italy is in 19th place. “Italy ranks 19th out of 38 countries as regards the general results on child well-being, only 34th out of 41 countries in terms of policies and conditions that generate well-being”, commented the president of Unicef ​​Italy Francesco Samengo. The report shows that in most rich countries, fewer than 4 out of 5 children feel satisfied with their life. Suicide is a leading cause of death among children aged 15-19. In addition, in the countries surveyed, about 1 in 3 children in all countries surveyed are either obese or overweight, and in more than a quarter of rich countries, child mortality is still above 1 in 1,000. On average, 40% of children in all OECD and EU countries – again according to the report – do not have basic reading and math skills by the age of 15. Before the outbreak of the Covid19 health emergency, the relative poverty of children in the 41 countries was on average 20%. “As far as mental health is concerned – explained Samengo – our country is 9th. Children with a high satisfaction with life at 15 in our country are 76%, compared to an average (in other countries ) of 75.7%, and the suicide rate is 2.5 per 100,000, compared to an average of 6.5 per 100,000. Concerning physical health, children’s overweight and obesity rates are of concern: l ‘Italy is 31st, with 36.9% of people between 5 and 19 years old who are overweight or obese “.

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