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Article ; Online: Cardiovascular Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Adults With Type 2 Diabetes.

Woo, Vincent C

Canadian journal of diabetes

2019 Volume 44, Issue 1, Page(s) 61–67

Abstract: Adults with type 2 diabetes mellitus can benefit from pharmacotherapies that lower their risk for cardiovascular disease. This review describes the salient findings from sodium-glucose cotransporter-2 (SGLT2) inhibitor cardiovascular outcome trials that ... ...

Abstract	Adults with type 2 diabetes mellitus can benefit from pharmacotherapies that lower their risk for cardiovascular disease. This review describes the salient findings from sodium-glucose cotransporter-2 (SGLT2) inhibitor cardiovascular outcome trials that serendipitously revealed the cardiorenal benefits of SGLT2 inhibitors in adults with type 2 diabetes mellitus who either have established cardiovascular disease or multiple cardiovascular risk factors. It also summarizes the findings from other phase 3 clinical studies that measured the cardiovascular effects of SGLT2 inhibitors and real-world evidence reports that compared the cardiovascular impact of SGLT2 inhibitors with other antihyperglycemic agents. The collective data indicate that SGLT2 inhibitors are pleiotropic agents that offer important cardiovascular, metabolic and renal benefits beyond glucose lowering with low incidences of hypoglycemia. Specifically, the placebo-controlled SGLT2 inhibitor cardiovascular outcome trials documented either fewer major adverse cardiac events (nonfatal myocardial infarction, nonfatal stroke and cardiovascular death) or a reduction in the composite endpoint of cardiovascular death or hospitalization for heart failure in participants with type 2 diabetes mellitus and established cardiovascular disease. Amongst those with type 2 diabetes mellitus who did not have established cardiovascular disease but did present with multiple risk factors, SGLT2 inhibitors lowered the combined endpoint of cardiovascular death or hospitalization for heart failure but had little impact on the occurrence of major adverse cardiac events. Ongoing clinical trials and subanalyses of the trials that have been reported should shed further light on the clinical benefits and utility of SGLT2 inhibitors.
MeSH term(s)	Adult ; Cardiovascular Diseases/chemically induced ; Cardiovascular Diseases/pathology ; Clinical Trials as Topic ; Diabetes Complications/chemically induced ; Diabetes Complications/pathology ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/pathology ; Humans ; Prognosis ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2019-09-24
Publishing country	Canada
Document type	Journal Article ; Review
ISSN	2352-3840
ISSN (online)	2352-3840
DOI	10.1016/j.jcjd.2019.09.004
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Review of the Clinical Efficacy and Safety of Insulin Degludec and Glargine 300 U/mL in the Treatment of Diabetes Mellitus.

Woo, Vincent C

Clinical therapeutics

2017 Volume 39, Issue 8S2, Page(s) S12–S33

Abstract: Purpose: The treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) using insulin is not ideal at this time. Despite advances made with basal insulin analogues, many individuals achieve less than optimal glycemic control or are ...

Abstract	Purpose: The treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) using insulin is not ideal at this time. Despite advances made with basal insulin analogues, many individuals achieve less than optimal glycemic control or are at risk for hypoglycemia. Currently available basal insulin analogues do not deliver steady, peakless, continuous insulin for >24 hours and are associated with adverse events, including hypoglycemia. The objective of this paper was to review the clinical efficacy and safety of upcoming long-acting insulin analogues such as insulin degludec and insulin glargine 300 U/mL (Gla-300). Methods: A comprehensive literature search of PubMed and Google Scholar was conducted from 1966 to 2015. The search included randomized controlled trials that specifically assessed the efficacy and safety of insulin degludec and Gla-300 in patients with T1DM and T2DM. Findings: The efficacy of insulin degludec and Gla-300 in achieving glycemic control has been reported in clinical trials in adults with T1DM and T2DM. Not only did a large number of patients succeed in meeting glycosylated hemoglobin targets, but they also experienced reductions in hypoglycemic events. These 2 therapies are associated with a reduced risk of nocturnal hypoglycemia and are generally well tolerated. Implications: The long-acting insulin analogues insulin degludec and Gla-300 are promising therapies in the treatment of T1DM and T2DM. Their improved insulin delivery for >24 hours offers glycemic control with a good safety profile.
Language	English
Publishing date	2017-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603113-4
ISSN	1879-114X ; 0149-2918
ISSN (online)	1879-114X
ISSN	0149-2918
DOI	10.1016/j.clinthera.2017.01.007
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Article ; Online: New Insulins and New Aspects in Insulin Delivery.

Woo, Vincent C

Canadian journal of diabetes

2015 Volume 39, Issue 4, Page(s) 335–343

Abstract: The major abnormality in both type 1 and type 2 diabetes is insulin deficiency. The methods of replacing insulin have improved throughout the decades, but hypoglycemia is still the limiting factor for many individuals with diabetes, and it prevents them ... ...

Abstract	The major abnormality in both type 1 and type 2 diabetes is insulin deficiency. The methods of replacing insulin have improved throughout the decades, but hypoglycemia is still the limiting factor for many individuals with diabetes, and it prevents them from achieving ideal glycemic targets. New insulin and newer delivery systems are being developed that can improve some of the limitations of current insulins or make the delivery of insulins more acceptable for some patients. Extending the duration of action of basal insulins and shortening the peak of fast-acting insulins may have advantages for individuals with diabetes. Different delivery systems may make insulin more acceptable to patients and may have other advantages, which may aid in attaining better glycemic control.
MeSH term(s)	Blood Glucose/drug effects ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy ; Drug Delivery Systems/methods ; Drug Delivery Systems/trends ; Humans ; Hypoglycemic Agents/administration & dosage ; Insulin/administration & dosage ; Insulin Glargine/administration & dosage ; Insulin, Long-Acting/administration & dosage ; Randomized Controlled Trials as Topic
Chemical Substances	Blood Glucose ; Hypoglycemic Agents ; Insulin ; Insulin, Long-Acting ; Insulin Glargine (2ZM8CX04RZ)
Language	English
Publishing date	2015-08
Publishing country	Canada
Document type	Journal Article ; Review
ISSN	2352-3840
ISSN (online)	2352-3840
DOI	10.1016/j.jcjd.2015.04.006
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Article ; Online: Anomalous origin of left main coronary artery from right coronary artery in a patient presenting with inferior wall myocardial infarction: a case report and literature review.

Ludhwani, Dipesh / Woo, Vincent

European heart journal. Case reports

2019 Volume 3, Issue 4, Page(s) 1–6

Abstract: Background: Anomalous origin of the coronary arteries is seen in less than 1% of the general population. Single coronary artery (SCA) is a congenital anatomic abnormality identified by a single coronary ostium giving rise to one coronary artery. We ... ...

Abstract	Background: Anomalous origin of the coronary arteries is seen in less than 1% of the general population. Single coronary artery (SCA) is a congenital anatomic abnormality identified by a single coronary ostium giving rise to one coronary artery. We present an extremely rare variant of the left main coronary artery (LMCA) branching off from the right coronary artery (RCA) and following a prepulmonic course. Case summary: A 72-year-old woman presented due to ongoing chest pain with associated ST-segment elevation involving the inferior leads. Emergent cardiac catheterization revealed a 99% ulcerated lesion in distal RCA, which was intervened on with angioplasty and stent placement. The RCA was noted giving rise to LMCA, which followed a prepulmonic course (anterior to pulmonary artery) before trifurcating into a small caliber left anterior descending, ramus intermedius, and hypoplastic left circumflex arteries. The non-malignant course of the aberrant LMCA was confirmed on the coronary computed tomography angiogram. The patient was discharged home on guideline-directed medical therapy. Discussion: The patient illustrated congenital SCA with type RIIA pattern of the aberrant vessel based on the Lipton anatomic classification for SCA. The prepulmonic course of SCA is usually benign and can be managed conservatively.
Language	English
Publishing date	2019-10-04
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytz169
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Article: Understanding the Clinical Profile of Insulin Degludec, the Latest Basal Insulin Approved for Use in Canada: a Narrative Review.

Woo, Vincent / Berard, Lori / Roscoe, Robert

Diabetes therapy : research, treatment and education of diabetes and related disorders

2020 Volume 11, Issue 11, Page(s) 2539–2553

Abstract: In recent years, the development of basal insulin therapies has focused on insulin analogues that have longer durations of action and more predictable pharmacokinetic/pharmacodynamic (PK/PD) profiles than their human insulin-based predecessors, such as ... ...

Abstract	In recent years, the development of basal insulin therapies has focused on insulin analogues that have longer durations of action and more predictable pharmacokinetic/pharmacodynamic (PK/PD) profiles than their human insulin-based predecessors, such as neutral protamine Hagedorn (NPH) insulin. Dosed once-daily, such analogues can provide a more stable glucose-lowering action, which translates clinically into a reduced risk of hypoglycemia. Insulin degludec (degludec) became available in Canada in 2017 and is the first basal insulin analogue to have a half-life exceeding the dosing interval. As well as offering the promise of an exceptionally flat PK/PD profile when at steady state, this characteristic means that insulin degludec can be dosed with some flexibility with regard to time of day and that it need not be taken at the same time each day. However, the approximately 25-h half-life also has some implications concerning dose titration. This article provides an up-to-date review of the study data describing the clinical profile of degludec, and aims to give helpful and practical advice to prescribers about its use. While the clinical benefits of degludec are described, it is also acknowledged that further study is required to better understand how its clinical performance compares with that of insulin glargine 300 units/mL.
Keywords	covid19
Language	English
Publishing date	2020-09-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2566702-6
ISSN	1869-6961 ; 1869-6953
ISSN (online)	1869-6961
ISSN	1869-6953
DOI	10.1007/s13300-020-00915-w
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Article: Emerging use of combination therapies for the management of type 2 diabetes - focus on saxagliptin and dapagliflozin.

Yu, Huan / Woo, Vincent C

Diabetes, metabolic syndrome and obesity : targets and therapy

2017 Volume 10, Page(s) 317–332

Abstract: Aims: The aim of this article is to review the safety and efficacy data of dapagliflozin, saxagliptin, and their combination in the management of patients with type 2 diabetes. Evidence for the use of the single-tablet combination formulation is also ... ...

Abstract	Aims: The aim of this article is to review the safety and efficacy data of dapagliflozin, saxagliptin, and their combination in the management of patients with type 2 diabetes. Evidence for the use of the single-tablet combination formulation is also presented. Methods: A nonsystematic literature review was performed using the Ovid, PubMed, and Google Scholar databases. Results: The addition of dapagliflozin/saxagliptin to metformin can lower mean hemoglobin A1c by as much as 1.47% and lead to weight loss of 0.5-2.0 kg. The risk of genital infections with combination therapy is lower than observed with dapagliflozin alone, suggestive of a protective effect. Adverse event risk at 52-week follow-up was not increased beyond that seen with either monotherapy. Conclusion: Dapagliflozin/saxagliptin combination is generally well tolerated and is an effective tool in helping patients with diabetes improve glycemic control.
Language	English
Publishing date	2017-07-21
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2494854-8
ISSN	1178-7007
ISSN	1178-7007
DOI	10.2147/DMSO.S117982
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Article: Greater Combined Reductions of HbA

Dungan, Kathleen M / Bardtrum, Lars / Christiansen, Erik / Eliasson, Johanna / Mellbin, Linda / Woo, Vincent C / Vilsbøll, Tina

Diabetes therapy : research, treatment and education of diabetes and related disorders

2023 Volume 14, Issue 8, Page(s) 1415–1425

Abstract: Introduction: A post hoc analysis of the PIONEER 1-5 and 8 trials assessed the clinically relevant composite endpoints of HbA: Methods: In the PIONEER trials, people with type 2 diabetes were randomised to orally administered semaglutide versus ... ...

Abstract	Introduction: A post hoc analysis of the PIONEER 1-5 and 8 trials assessed the clinically relevant composite endpoints of HbA Methods: In the PIONEER trials, people with type 2 diabetes were randomised to orally administered semaglutide versus placebo (PIONEER 1, 4, 5 and 8), empagliflozin (PIONEER 2), sitagliptin (PIONEER 3) and liraglutide (PIONEER 4) for 26-78 weeks. This analysis assessed the proportion of people achieving an HbA Results: Overall, 3506 people in PIONEER 1-5 and 8 were included. At week 26 and at end of treatment, odds of achieving the composite endpoint of an HbA Conclusion: In PIONEER 1-5 and 8, odds of achieving clinically relevant reductions in both HbA
Language	English
Publishing date	2023-05-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2566702-6
ISSN	1869-6961 ; 1869-6953
ISSN (online)	1869-6961
ISSN	1869-6953
DOI	10.1007/s13300-023-01413-5
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Article ; Online: Management of type 2 diabetes, obesity, or nonalcoholic steatohepatitis with high-dose GLP-1 receptor agonists and GLP-1 receptor-based co-agonists.

Goldenberg, Ronald M / Gilbert, Jeremy D / Manjoo, Priya / Pedersen, Sue D / Woo, Vincent C / Lovshin, Julie A

Obesity reviews : an official journal of the International Association for the Study of Obesity

2023 Volume 25, Issue 3, Page(s) e13663

Abstract: Type 2 diabetes (T2D), obesity, and nonalcoholic fatty liver disease/nonalacoholic steatohepatitis (NAFLD/NASH) share mutual causalities. Medications that may offer clinical benefits to all three conditions are being developed. Glucagon-like peptide-1 ... ...

Abstract	Type 2 diabetes (T2D), obesity, and nonalcoholic fatty liver disease/nonalacoholic steatohepatitis (NAFLD/NASH) share mutual causalities. Medications that may offer clinical benefits to all three conditions are being developed. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for the management of T2D and obesity and there is great interest in evaluating higher doses of available GLP-1RAs and developing novel GLP-1RA-based co-agonists to provide greater reductions in glycated hemoglobin (HbA1c) and body weight as well as modifying NAFLD/NASH complications in clinically meaningful ways. High-dose GLP-1RAs and multi-hormonal strategies including GLP-1R agonism have either already been approved or are in development for managing T2D, obesity, or NASH. We provide a mechanistic outline with a detailed summary of the available clinical data and ongoing trials that are adjudicating the impact of high-dose GLP-1RAs, unimolecular, and multimolecular GLP-1R-based co-agonists in populations living with T2D, obesity, or NASH. The available trial findings are aligned with preclinical observations, showing clinical efficacy and safety thus providing optimism for the expansion of GLP-1R-based drug classes for managing the triad of T2D, obesity and NASH. Development, access, and wide-spread utilization of these new therapeutic approaches will offer important opportunities to markedly improve the collective global burden of T2D, obesity, and NASH.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/drug therapy ; Non-alcoholic Fatty Liver Disease/drug therapy ; Hypoglycemic Agents/pharmacology ; Hypoglycemic Agents/therapeutic use ; Glucagon-Like Peptide-1 Receptor Agonists ; Glucagon-Like Peptide-1 Receptor/agonists ; Obesity/complications ; Obesity/drug therapy
Chemical Substances	Hypoglycemic Agents ; Glucagon-Like Peptide-1 Receptor Agonists ; Glucagon-Like Peptide-1 Receptor
Language	English
Publishing date	2023-11-15
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2147980-X
ISSN	1467-789X ; 1467-7881
ISSN (online)	1467-789X
ISSN	1467-7881
DOI	10.1111/obr.13663
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Article ; Online: Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes: response to Nathan et al.

Woo, Vincent

Diabetes care

2009 Volume 32, Issue 3, Page(s) e34; author reply e37–8

MeSH term(s)	Algorithms ; Diabetes Mellitus, Type 2/drug therapy ; Europe ; Evidence-Based Medicine ; Humans ; Hyperglycemia/complications ; Hyperglycemia/drug therapy ; Hypoglycemic Agents/therapeutic use ; Metformin/therapeutic use ; Societies, Medical ; Thiazolidines/therapeutic use ; United States
Chemical Substances	Hypoglycemic Agents ; Thiazolidines ; thiazoline-2-thione (5685-05-2) ; Metformin (9100L32L2N)
Language	English
Publishing date	2009-03
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc08-2093
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Article ; Online: Use of flash glucose monitoring is associated with HbA1c reduction in type 2 diabetes managed with basal insulin in Canada: A real-world prospective observational study.

Abitbol, Alexander / Jain, Akshay B / Tsoukas, Michael A / Sigalas, John / Galm, Brandon P / Lee, Jooho / Qureshy, Kamran S / Collins, Caitlyn / Woo, Vincent C

Diabetes & vascular disease research

2024 Volume 21, Issue 3, Page(s) 14791641241253967

MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Glycated Hemoglobin/metabolism ; Prospective Studies ; Blood Glucose/metabolism ; Blood Glucose/drug effects ; Hypoglycemic Agents/therapeutic use ; Hypoglycemic Agents/adverse effects ; Blood Glucose Self-Monitoring ; Glycemic Control/adverse effects ; Treatment Outcome ; Biomarkers/blood ; Female ; Male ; Middle Aged ; Canada/epidemiology ; Predictive Value of Tests ; Aged ; Time Factors
Chemical Substances	Glycated Hemoglobin ; Blood Glucose ; Hypoglycemic Agents ; hemoglobin A1c protein, human ; Biomarkers
Language	English
Publishing date	2024-05-11
Publishing country	England
Document type	Observational Study ; Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	2250793-0
ISSN	1752-8984 ; 1479-1641
ISSN (online)	1752-8984
ISSN	1479-1641
DOI	10.1177/14791641241253967
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