ИСТИНА

Background and aims: The increased number of cardiac complications (CC) in patients with type 2 diabetes (T2DM) is well known, therefore, physicians should pay more attention to the treatment recommendations due to protective effects on the cardiovascular system of certain glucose lowering medications (GLM). The aim of our study was to access the data on frequency of use of different GLM according to the presence or absence of several CC in T2DM patients in real clinical practice. Materials and methods: The analysis performed based on the national registry data and included all adult patients (≥18years old) with T2DM (n=4449684) at 01.01.2020. For all patients we estimated the reported cases of myocardial infarction (MI), coronary heart disease (CHD) and hypertension according to registry data as well as treatment at the time of survey. We divided all T2DM patients into the therapy groups according the presence of certain drug (in monotherapy or combination) and then analysed these groups depending on the reported CC frequency. IBM SPSS Statistics ver 22.0 was used to process the data. Results: The structure of prescribing GLM and proportion of T2DM patients on therapy with certain CC presented in the table. The use of traditional classes dominates with common use of insulin, metformin (Met) and sulfonylurea (SU). In total T2DM patients the most frequently prescribed classes were Met (74,4%), SU (53,1%) and insulin basal (19,2%) and bolus (12,6%). The new GLM classes such as inhibitors of dipeptylpeptidase-4 (iDPP-4), inhibitors of sodium glucose co-transporter 2 (iSGLT-2), agonist receptor glucagon-like peptide type 1 (arGLP-1) not widely distributed currently (7,9%, 2,5% and 0,2%, respectively), though they have the proved protective effects on the cardiovascular system, with slight, but significant increase into iDPP-4 and iSGLT-2 groups with the combined CC (from 0 to 3). We observed significant difference between GLM groups with bigger rise of proportion of T2DM patients on traditional (insulin and SU)- more then 2 times, compared to the new drugs (iDPP-4and iSGLT-2) with rising CC presence and frequency (0-3), while Met and arGLP-1 use remain rather stable. Separate analysis was made according to the exact CC (yes or no): in patients with CC we observed bigger proportion on therapy with all GLM except arGLP-1 (stable) and less Met use in groups with MI and CHD. Conclusion: We observed the relation between the therapy and CC in T2DM patients in real clinical practice. The therapy for T2DM should be encouraged in compliance with the new clinical recommendations and more active introduce the classes of drugs with evidence of reducing cardiovascular risk.