ISSN (Print): 1574-8863
ISSN (Online): 2212-3911
Volume 16, 3 Issues, 2021
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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911
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Dr. Alina Poperno (Enfocement and Inspection Division, Israeli Ministry of Health, Eliav 9, Jerusalem 9546208, Israel)
Has contributed: A Case of Hepatotoxicity Induced by Adulterated “Tiger King”, a Chinese Herbal Medicine Containing Sildenafil
5 Abstract Ahead of Print are available electronically
13 Articles Ahead of Print are available electronically
Diabetes mellitus (DM) has already affected one in every eleven person in the global population, and the dis-ease prevalence continues to increase because of the obesity pandemic. Even with the availability of a multitude of antidi-abetic medications for optimal glycaemic control, cardiovascular morbidity and mortality were not largely altered until re-cently when newer antidiabetic drugs such as glucagon-like peptide-1 receptor analogues (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors were introduced. Cardiovascular safety of antidiabetic drugs has also been a hot topic for global scientific debate after the US Food and Drug Administration (FDA) enforced restrictions on Rosiglita-zone in 2010 with the suspicion of increased mortality and myocardial events (with subsequent uplift of the ban on the drug in 2013 following the emergence of additional evidence on safety). After this debate, all antidiabetic should go through rigorous safety checks with cardiovascular outcome trials (CVOTs). Recent CVOTs with GLP-1RAs and SGLT2 inhibitors have revealed markedly positive outcomes that have changed the landscape of diabetes management across the world. Thus, the therapeutic algorithm for optimal management of DM should consider not only the glycaemic control ef-ficacy of the individual antidiabetic agent but also the cardiovascular safety and modifications in other anticipated long-term DM complication profiles. Therefore, it is imperative to critically appraise the efficacy and cardiovascular safety of all antidiabetic drugs to improve the scientific practice of our diabetes care globally. This issue, “Efficacy and cardiovas-cular safety of antidiabetic medications,” provides readers the back-up of up to date evidence.
The incidence and prevalence of diabetes have been increasing worldwide and the WHO now estimates that more than
480 million people are affected worldwide. Effective management with few side effects is thus needed. This special issue
addressed the current status of treatment and side effects of drugs used for the management of diabetes.
The complications stemming from diabetes per se may be many. They may affect the large vessels causing cardiovascular
and cerebrovascular disease. The small vessels may be affected, causing retinopathy, nephropathy and neuropathy.
Regarding the cerebrovascular effects, one of the side effects may be more falls and thus more fractures. The paper by
Rasmussen et al.  analyses risk factors for falls in diabetes, pointing at a number of frequently used drugs that may contribute
to falls in diabetes (selective serotonin reuptake inhibitors, opioids) and thus partly explain the increased risk of fractures.
Also eye disease may contribute to an increased risk of falls and impair quality of life. The paper by Nissen et al. 
summarizes the effects of biological treatment in diabetic retinopathy with diabetic macular edema and its potential.
The paper by Røikjer et al.  shows the advances in the detection and treatment of peripheral diabetic neuropathy,
alluding to the new developments and possibilities within this field.
One of the main causes of morbidity and mortality in diabetes is cardiovascular disease. The paper by Pietraszek 
summarizes the current knowledge about the effects of glucose lowering drugs in terms of cardiovascular outcomes and safety.
One of the major new drugs, which have improved cardiovascular, is sodium glucose co-transporter two inhibitors (SGLT2
inhibitors). However, rare but important side effects of these drugs need to be kept in mind.
The paper by Laursen et al.  points to the increased risk of euglycemic ketoacidosis in patients with type 2 diabetes
using these drugs and thus the need of awareness of this in patients receiving this class of drugs.
The paper by Werkmann et al.  examined the previously suspected potential for detrimental outcomes of peripheral
ischemia and lower limb amputations finding no increased risk of this compared to the use of sulphonylurea treatment as glucose
The special issue thus reviews important topics and advances within these and brings knowledge in the field up to date.
I hope you will have as much pleasure from reading the papers as I have had.