Debbie Rigby rounds up the latest in research news 

Effects of empagliflozin on the urinary albumin-to-creatinine ratio in patients with type 2 diabetes and established cardiovascular disease

Analysis from the EMPA-REG OUTCOME randomised, placebo-controlled trial provides more evidence of the renoprotective effects of SGLT2 inhibitor empagliflozin in patients with type 2 diabetes and cardiovascular disease. At week 12, compared with placebo, empagliflozin slowed urinary albumin-to-creatinine ratio progression in normoalbuminuric patients by 7% and reduced urinary albumin-to-creatinine ratio by 25% in microalbuminuric patients and by 32% in macroalbuminuric patients.

Lancet Diabetes Endocrinol 2017.

Medscape summary

 

Cholecalciferol improves glycemic control in type 2 diabetic patients

A 6-month prospective interventional study has shown that vitamin D supplementaton improves blood glucose control and cholesterol profile in vitamin D-deficient paeople with type 2 diabetes. Supplementation with cholecalciferol 45,000 units once weekly for 8 weeks, then 22,5000 units once weekly for 16 weeks reduced total cholesterol, LDL-C, parathyroid hormone, alkaline phosphatase, serum creatinine, and pulse rate. Triglycerides and high-density lipoprotein cholesterol, both systolic and diastolic BP, and BMI did not show significant change.

Therapeutics and Clinical Risk Management 2017:13 813–820.

 

The efficacy and safety of estriol to treat vulvovaginal atrophy in postmenopausal women

This systematic review of 22 studies (n=1217) confirmed the efficacy of local oestrogen therapy for the treatment of vulvovaginal atrophy in postmenopausal women. The available evidence shows that vaginal oestradiol preparations appear safe for women who have risk factors related to systemic oestrogen therapy.

Climacteric 2017;20:321-330.

 

Blood pressure targets

Clinical trial experience generally suggests that the ‘lower is better than higher’ approach to BP management is appropriate for many patients. Careful follow-up and monitoring for adverse effects is essential when intensive BP lowering is instituted. Electrolyte abnormalities and a modest reduction in GFR are the most likely adverse effects and can usually be addressed by careful monitoring and/or modification of the treatment regimen.

Eur Heart J. 2017;38(15):1091-1092.