World Diabetes Day: the vital link between gum disease and diabetes

From nature.com

On World Diabetes Day, 12 November 2024, the European Federation of Periodontology (EFP) called attention to the growing body of scientific evidence that underscores the critical connection between gum disease (periodontitis) and diabetes.

As diabetes continues to impact millions of lives globally, understanding its effects on oral health (as well as the effects of gum disease on diabetes) is essential for improving overall health. This year's theme, Diabetes and wellbeing, emphasised the need for accessible care and support for all individuals living with diabetes - and that includes prioritising gum health.

Anton Sculean, chair of EuroPerio11, the premier congress in periodontology, hosted by the EFP, said: ‘Recent research has shown that diabetes is not only a major risk factor for periodontitis but that the relationship between the two conditions is bidirectional, meaning they both influence and exacerbate one another. Moreover, moderate/severe periodontitis is associated with an increased risk of all-cause and CVD-related mortality in adults with diabetes.'

People with diabetes are significantly more susceptible to developing severe gum disease, with studies showing that they are at a threefold higher risk. The connection between these conditions is particularly evident in patients with poorly controlled blood sugar levels. The higher the level of hyperglycaemia, the more severe the gum disease tends to be. This is due to the impact of high blood sugar on the immune system, which weakens the body's ability to combat infections, including those in the gums. Additionally, diabetes disrupts the body's inflammatory response, resulting in an exaggerated immune reaction in the gums that leads to further tissue damage.

Conversely, periodontitis can complicate diabetes management. The inflammation caused by gum disease isn't confined to the gums; it can spread throughout the body, increasing systemic inflammation and, in turn, impairing insulin sensitivity. This makes it harder for people with periodontitis to control their blood sugar levels, contributing to a vicious cycle that complicates both conditions. Furthermore, it has been demonstrated that severe periodontitis may be a risk indicator to develop diabetes in patients initially normoglycemic.

Emerging evidence shows that treating periodontitis can lead to improved glycaemic control in people with diabetes, highlighting the importance of integrated care. This finding reinforces the need for dental professionals to work closely with other healthcare providers, ensuring that patients receive comprehensive care that addresses both their oral health and diabetes management.

The EFP has been a leader in raising awareness about the strong link between gum disease and diabetes. This topic will take centre stage at the upcoming EuroPerio11 congress in Vienna (14-17 May 2025). A dedicated session will explore clinical considerations for managing patients with diabetes and periodontal disease, including screening for diabetes in dental settings.

This World Diabetes Day, the EFP called on healthcare professionals, policymakers, and the public to ensure that gum health is part of diabetes care and to improve the well-being of people living with diabetes by supporting comprehensive and holistic healthcare systems that address the complex connections between oral and general health. 

https://www.nature.com/articles/s41415-024-8192-z

TRICARE Tips for Managing Diabetes and Your Oral Health

From newsroom.tricare.mil

Diabetes is a common condition in the United States. According to the Centers for Disease Control and Prevention, more than 38 million American adults currently have diabetes.

“Even though diabetes is common, many people don’t know about its connection to oral health,” said Douglas Elsesser, a program analyst with the Dental Program Section of the TRICARE Health Plan. “Uncontrolled diabetes can negatively affect your oral health in many ways.”

If you have diabetes, it’s important to keep it under control. Here are some examples of how diabetes can affect your oral health:

• Reduced saliva production. Saliva helps clean bacteria and neutralize acids that cause tooth decay. Having less saliva increases your risk for cavities.
• Rapid bacteria growth. High blood sugar levels allow bacteria in the mouth to multiply quickly. Oral bacteria causes gum disease and other infections.
• Increased plaque build-up. Plaque is a film of bacteria that sticks to teeth. Unchecked diabetes increases plaque build-up. This increases your risk for gum disease.
• Decreased ability to fight infections. People with diabetes are more prone to gingivitis and advanced gum disease. These infections can destroy gum tissue and bone, leading to tooth loss.

Poor oral health also makes diabetes harder to manage. Gum disease causes inflammation, which can spike blood sugar levels, which is a concern for people with diabetes.

To properly care for your oral health, you can adopt these practices:

• Brush your teeth twice a day and floss daily.
• Seek treatment right away if you show any signs of gum disease. Early signs of gum disease include swollen gums, gums that bleed easily, and bad breath that won’t go away.
• Coordinate treatment with your dentist and physician.
• Quit smoking and using tobacco.
• Limit the amount of sugar you eat and drink.
• Chew sugar-free gum to increase saliva flow.

https://newsroom.tricare.mil/News/TRICARE-News/Article/3826414/tricare-tips-for-managing-diabetes-and-your-oral-health 

One secret to preventing dementia, diabetes, and heart disease may lie in your oral health habits. Here’s the dental routine to follow

From fortune.com

While the connection between oral health and general health is well documented, it’s not generally discussed at well or dental visits. It should be: An April 2022 report from The National Institutes of Health found that 90% of adults ages 20 to 64 experience tooth decay, while almost 50% of adults 45 to 64 have gum disease. 

Dr. Michael Roizen, chief wellness officer at Cleveland Clinic, says oral diseases have a large association with overall health. Research has shown that there’s an association between your dental health habits and whether or not you develop diabetes, Alzheimer's, stroke or heart disease.

When we don’t take care of our oral health, says Roizen, dental caries (tooth decay) and gum disease can enter the bloodstream, contributing to plaque disruption in the arteries, or promoting inflammation in the brain and other areas of the body. “Flossing your teeth is the equivalent of 8,000 steps a day,” says Roizen. “Which is pretty darn powerful.”

Think of the body as a human doughnut

In 2019, the World Health Organization named tooth decay in permanent teeth as the most common health condition in its Global Burden of Disease report. Oral diseases affect about 3.5 billion people worldwide

What we often don’t realize is that this isn’t bad just for our mouths, but our bodies. “People think of their heads and teeth as disconnected from the rest of their bodies, but they’re not,” says Dr. Maria Ryan, DDS, Ph.D. in oral biology and chief clinical officer at Colgate-Palmolive Company. Viewing the body as one connected system helps reinforce how it can influence all areas of wellness and the importance of maintaining good oral hygiene, says Ryan.  

Naveem Jain, founder of Viome, a company that builds personalized toothpaste and supplements based on a person’s microbiome, compares the human body to a donut. “There is a tube that goes through us,” says Jain, noting that billions of microbes enter the body through that tube as we breathe. “When the protective barrier is broken, you have system inflammation in the body. If you have a leaky gum, it’s the same concept. If our heart is bleeding or even our fingers, we’d be trying to figure it out. If our gums are bleeding, eh whatever. In both cases, all of your microbes have a free path into the bloodstream.”

That path is where trouble starts, says Ryan. It’s no surprise then that in one study, published in Hypertension, an American Heart Association journal, found that  people with gum disease were twice as likely to have a heart attack and three times as likely to have a stroke than those without inflammatory gum disease. “People think, ‘What’s the worst thing that can happen? I can lose a tooth,’” says Ryan. “Well, it could be worse than that.”

Poor oral health can also impact our confidence

If the prospect of developing heart disease or diabetes isn’t enough to get you to the dentist, maybe the idea of looking good will. After all, dental hygiene is also front and centre in all of our human interactions. If you’re self-conscious about bad breath or missing teeth, it might affect your ability to move through the world with confidence. “That can impact someone’s ability to get a job, or their relationships,” says Ryan. “It’s important on so many levels.”

And weak teeth can impact the way you’re able to address more mundane aspects of your health. Ryan uses the example of a healthy diet. If a physician recommends eating more fruits and vegetables to a patient with poor oral health, the patient may feel stuck eating foods such as apples, carrots, and broccoli if missing teeth and cavities are a factor, Ryan says. 

When all of these factors impede a person’s ability to be social and engaged on a personal level, their mental health can suffer. One 2022 study documented the connection between poor oral health and increased anxiety and depression.

While the overall connection between oral health and overall health is well documented, it’s not generally discussed at well or dental visits.       GETTY IMAGES

How to protect your oral health and overall well-being

A big part of addressing the oral health crisis is prevention and education, says Ryan who leads Colgate-Palmolive’s five-year, $100 million Know Your OQ (oral health quotient). It aims to shift some of these statistics and increase awareness on the importance of simple and consistent oral hygiene. 

The American Dental Association and WHO recommend six basic steps for preventing gum disease: 

1. Brush twice a day for two minutes
2. Floss once a day.
3. See your dentist every six months.
4. Limit sugary drinks and snacks.
5. Avoid all forms of tobacco
6. Use protective equipment during sports 

It might seem like really basic information, says Ryan, but if everyone was doing it the stats on oral health wouldn’t be what they are. 

Dr. Tien Jiang, a practicing dentist who teaches oral health policy and epidemiology at Harvard School of Dental Medicine, says she takes every opportunity she can to weave education into her interactions with patients so her approach is more preventative than reactive whenever it can be. “Just like high blood pressure, with a lot of dental diseases or concerns—for instance, an early cavity—you can’t feel anything,” says Jiang. “You might not feel anything until it’s advanced. You can have a patient come in and a dentist diagnoses five cavities and they’ve been feeling fine.”

But at that point, the situation has turned urgent and the patient is in tremendous pain—especially in the case of periodontal disease, says Jiang. To add insult to injury the patient now also faces a steep dental bill to cover care and save the tooth. “We have an uphill battle,” she says. “We want to diagnose but there’s always a suspicion that the dentist just wants to make money.”

From Ryan’s perspective, this makes education and normalization of these ideas critical to shift the trajectory of how we frame and prioritize our oral health. 

Relatedly, she says, knowing where to get dental care could also be a barrier. Aside from dental practices, dental schools offer cleanings, as well as federally qualified health centres (FQHC). “Not just preventative strategies, but also the signs and symptoms so if they have disease they go and get it managed. There are so many places to get care.”

https://fortune.com/well/article/oral-health-connection-diabetes-heart-disease-alzheimers/ 

Diabetes warning: I’m a dentist and here’s why not brushing your teeth could be deadly

From the-sun.com

DIABETES is a serious health condition that can impact other areas of your wellbeing.

It's a lifelong illness that causes your blood sugar to be too high and if not treated properly, can lead to debilitating symptoms such as poor eye sight and gum disease.

1

If you're a diabetic and you don't brush your teeth properly, it could lead to other serious health problems, one dentist has warned           Credit: Alamy

It's because of this that one expert has highlighted the key dangers diabetics face when it comes to oral health.

Speaking to The Sun, London-based dentist Dr Monik Vasant explained that poorly controlled diabetics may have high blood sugar levels for a long period of time.

He said: "Too much sugar in your blood can lead to more sugar in your saliva.

"This provides a perfect breeding ground for bacteria, which produces acid and toxins that attacks your tooth enamel and damages your gums."

Dr Monik, who is currently working with Colgate Total on the #HappyHabits campaign, said it's important to note that when oral bacteria is not controlled effectively and inflammation associated with severe gum problems exists, this can also increase a person's risk of certain deadly diseases.

He explained that cardiovascular disease is one of them.

"There is some evidence to suggest that blocked arteries, heart disease and stroke may be linked to the inflammation caused by oral bacteria", he said.

When you have diabetes you are more at risk of cardiovascular disease than others who don't have the condition.

It affects your circulation and can lead to other issues with your feet and eyesight, as well as heart attacks and strokes.

Dr Monik explained that endocarditis is another issues that could be linked.

He said: "Bacteria from your mouth travels through the bloodstream and attaches to the lining of your heart chamber and/ or valves creating pockets of bacteria.

"This can disrupt the blood flow through the heart."

He added that pneumonia and other respiratory diseases are also caused when bacteria travels from the mouth to the lungs.

Dr Monik said it's imperative that diabetics take good care of their oral health.

He explained that people with type 2 diabetes are around three times more likely to develop oral problems than people without, and those with type 1 diabetes are also more at risk.

He said: "You’re more likely to develop things like gum disease which may result in bad breath, bleeding gums, gum recession, and eventually tooth loss. In addition, diabetics are at a higher risk of getting oral thrush which is a fungal infection of the mouth.

"Looking after your mouth health starts at home and doesn’t need to be costly or complicated.

"Simple things like remembering to brush twice a day for two minutes with an antibacterial toothpaste, cleaning in between the teeth, and changing your toothbrush or toothbrush head every three months will help to prevent common oral problems developing in the first place." 

KNOW THE SIGNS

Dr Monik said the key thing diabetics need to look out for, is bleeding gums.

He said: "The early signs of gum problems are things like red, sore or bleeding gums, bad breath, gum recession, loose teeth.

"The signs of oral thrush include white patches within the mouth, redness of the tongue and cracking of the skin at the corner of the lips.

"If you notice these, don’t ignore them and make an appointment with your dentist.

"Getting the right treatment early can prevent severe infections, tooth loss and other complications down the road."

Brushing and flossing properly is important for everyone, but especially so for diabetics as they’re more at risk of developing oral health issues, Dr Monik said.

"If we don’t follow simple oral care practices like brushing twice a day for two minutes with an antibacterial toothpaste, cleaning in between the teeth with floss or interdental brushes, and changing our toothbrush or toothbrush head every three months, we could end up with tooth decay and gum disease, which could in turn lead to painful cavities, abscesses or even tooth loss", he added.

Dr Monik said that we are all capable of managing our oral health at home by implementing simple regimes like brushing twice a day with an antibacterial toothpaste.

He said that this goes a long way in reducing the oral bacteria which may predispose common oral health issues.

"However, we must still acknowledge that poor oral hygiene can manifest in a number of different ways and knowing the signs of when to get checked out is important!

"If you are worried about your oral health and experience such symptoms like tooth pain, bleeding or swollen gums, non-healing ulcers, growths within the mouth, changes in the tongue's texture or colour I would encourage you to make an appointment to see your dentist", he added.

https://www.the-sun.com/health/4631818/diabetes-warning-dentist-not-brushing-teeth-deadly/ 

Does diabetes affect oral health?

From indianexpress.com

An endocrine disorder, diabetes not only affects various organs of the body, it also has an impact on oral health, said Dr Abhijeet Sharan

Uncontrolled blood sugar levels can affect the eyes, kidneys, nerves, heart, brain, and other body organs, but did you know that it can also affect oral health?

People with high blood sugar levels are at an elevated risk of developing tooth and gum ailments because they have lowered resistance to infection. Also, diabetes can slow down healing, which may interfere with the treatment of periodontal disease, said Dr Abhijeet Sharan, DNB (general medicine), DTM&H, MACP, senior consultant physician (Medica North Bengal clinic).

An endocrine disorder, diabetes not only affects various organs of the body, it also has an impact on oral health, said Dr Sharan.

Diabetes has an impact on oral health too. (Source: Gettyimages/Thinkstock)

What are the common oral health problems that affect diabetics?

Gum abscesses, periodontal disease, fungal infections such as thrush, tooth decay, mouth ulcers, altered taste, and dry mouth.

What is periodontal or gum disease, and how does it affect people with diabetes?

Periodontal or gum disease is a type of infection that destroys the bone surrounding and supporting the teeth. The destruction of the bone that holds the teeth into the jawbone can cause difficulty in chewing.

Sometimes the destroyed bone can house bacteria and food debris, leading to the formation of plaque. If this plaque is left untreated on the teeth and gums, it can harden and form tartar around the gums, which may cause bleeding.

Symptoms of gum disease are

*Red, tender, bleeding gums with swelling
*Continual pus discharge from the gums
*Teeth get loose and pull away from the gums
*Foul taste
*Foul breath
*Deposition of plaque and tartar

Ways to have a healthy oral condition when you have diabetes (Source:Gettyimages/Thinkstock)

Why are people with diabetes prone to tooth decay and cavities?

People with increased blood sugar levels have high sugar levels in their saliva with dry mouths.

“When interacting with the bacteria present in the mouth, the high sugar content of the saliva may cause the formation of acid, which slowly dissolves the enamel of the teeth, causing a cavity,” said Dr Sharan.

People with diabetes must regularly visit their dentist to get their teeth cleaned thoroughly. Also, they must maintain proper oral hygiene to prevent cavities and gum disease.

Why are diabetics at greater risk of developing oral fungal infections?

Oral thrush or candidiasis is the most common oral fungal infection caused by an overgrowth of the yeast, which occurs naturally in the mouth. Dry mouth, high glucose levels in saliva and poor resistance to fight an infection contribute a perfect condition for the yeast to grow in the oral cavity.

“The oral thrush exhibits itself as white or red in the inner lining of the mouth. Sometimes the oral thrush can cause painful ulcers. By controlling the blood glucose levels people with diabetes can avoid developing oral thrush,” he mentioned.

How can people with diabetes take care of their oral health?

If you have diabetes and wish to prevent developing tooth and gum problem, it is advisable to:
*Add plenty of green and leafy vegetables to your diet.
*Take your medicine as suggested by the doctor.
*Clean your teeth with fluoride rich toothpaste twice a day.
*Clean your teeth with dental floss to avoid accumulation of food debris between two teeth.
*Avoid having a dry mouth – drink plenty of water or chew sugar-free gum.
*Avoid smoking cigarettes.

https://indianexpress.com/article/lifestyle/health/diabetes-oral-health-blood-sugar-infection-periodontal-disease-7428481/

‘Extra attention’ to oral health pays off among patients with type 2 diabetes

From healio.com

A dental intervention among patients with type 2 diabetes improved their oral health-related quality of life, a pilot study in the Netherlands showed.

Periodontitis is a complication of diabetes mellitus, according to researchers. In addition, patients with diabetes appear to have a higher prevalence of other oral conditions such as dry mouth, Candida infections, taste disorders and oral malignancies.

“Clinical, fundamental and epidemiological research into the connection between diabetes and oral health has been accumulating over several decades,” Martijn J. L. Verhulst, a PhD candidate in the department of periodontology at the University of Amsterdam and Vrije Universiteit in the Netherlands, told Healio Primary Care. “We believed now was the time to investigate how clinicians in primary care could use that knowledge on a daily basis, in a way that actually benefits patients.”

Martijn Verhulst

Verhulst recruited 24 family medicine practices and randomly assigned them in a 1:1 ratio to be part of an experimental cohort or a control cohort. The practices chose which patients with type 2 diabetes would participate in the study. Those in the experimental cohort received:

• repeated messages about the importance of good oral health and the need to brush twice daily with a soft toothbrush and a fluoride toothpaste;
• frequent encouragement to visit a dentist and, since oral care is not covered under the Netherlands’ mandatory basic health care insurance, the paperwork that would be required to see a dentist twice annually; and
• kits that contained oral hygiene products and a brochure with information on the link between diabetes and oral health.

The family practitioners in the control cohort did not provide any “extra attention to oral health” for their patients with diabetes, Verhulst and colleagues wrote in Annals of Family Medicine.

The researchers reported that among the 764 patients in the study, 543 completed most of the 14-item Oral Health Impact Profile — a survey that measures frequency of functional limitations, physical pain, psychologic difficulties, handicaps and physical, psychologic and social disabilities — at baseline and 1 year later.

More patients in the experimental cohort said their oral health improved compared with the control cohort (35.2% vs. 25.9%; P = .046). A secondary post hoc analysis that included the 18 family medicine practices where 60% or more of the patients completed the Oral Health Impact Profile also favoured the experimental cohort (38.3% vs. 24.9%, P = .011). There was no significant improvement in the number of self-reported oral health complaints among the cohorts, and the researchers said that the experiment had a minimal effect on the general health of its participants.

Verhulst encouraged physicians to find time to discuss oral health with their patients.

“In a number of cases, this will result in the identification of previously undiagnosed periodontitis, which can then be treated appropriately,” he said in the interview. “Beyond this potential benefit, the impact poor oral health has on quality of life, social life, speech, self-confidence, chewing, pain, loss of productivity, etc., should be reason enough to strive for an interdisciplinary approach.”

Lisa Simon, MD, DMD

In many ways, this study proves what we already know about lots of other health outcomes and behaviours: motivational interviewing and longitudinal support from a primary care team helps empower patients. It is high time these principles were also applied to oral health.

This study leverages the team‐based care and trusting primary care relationships patients already had to help them achieve better oral health, something all of us who work in primary care should aspire to. I also think it is wonderful that this study focused on oral health‐related quality of life — a patient‐centred outcome.

While there is a developing evidence base that suggests oral health may affect diabetes outcomes, what is far more important is that oral health causes unnecessary suffering for far too many people. Independent of quantitative clinical outcomes, allowing people to live happier lives is an outcome worth celebrating.

Lisa Simon, MD, DMD

Fellow, oral health and medicine integration, Harvard School of Dental Medicine

https://www.healio.com/news/primary-care/20210622/extra-attention-to-oral-health-pays-off-among-patients-with-diabetes

Brush your teeth three times a day 'to ward off diabetes'

From sports.yahoo.com

Brushing your teeth three times a day could ward off diabetes, research suggests.

While it may sound farfetched, oral hygiene has long been linked to good heart health.

Allowing teeth to decay is thought to trigger gum inflammation, with “swelling” also playing an “important role in the development of diabetes”.

   Scientists found a link between oral health and the risk of diabetes, particularly among women.                                                                                       (Getty Images)

To learn more, scientists from Seoul Hospital looked at the oral health of more than 188,000 people over 10 years.

They found those who brushed their teeth at least three times a day were 8% less likely to develop either type 1 or 2 diabetes.

Gum disease raised the risk by 9%, while having 15 or more missing teeth boosted the odds by 21%.

“Frequent tooth brushing may decrease the risk of new-onset diabetes, and the presence of periodontal [gum] disease and increased number of missing teeth may increase that risk,” the scientists wrote in the journal Diabetologia.

“Overall, improving oral hygiene may be associated with a decreased risk of occurrence of new-onset diabetes.”

Last year, 3.9 million people in the UK had been diagnosed with diabetes. Around 90% of patients have type 2.

In the US, 34.2 million had the condition that year, of whom just 1.6 million were type 1.

Type 2 diabetes occurs when the insulin made by the pancreas does not work properly or not enough is produced to effectively lower blood sugar levels. It is associated with carrying too much weight.

Type 1 diabetes is an autoimmune disorder that comes about when the body does not produce insulin.

Left untreated, both have been linked to heart disease, kidney damage, blindness and even limb amputations.

To better understand how oral health influences a person’s diabetes risk, the scientists looked at participants of the National Health Insurance System-Health Screening Cohort in Korea.

This collected information on the participants’ medical history and oral hygiene habits.

Overall, brushing teeth more than three times a day was linked to an 8% lower risk of diabetes, while gum disease and having many missing teeth raised the odds by 9% and 21%, respectively.

This remained true after the scientists adjusted for BMI, blood pressure, activity levels, smoking and alcohol consumption.

The results also varied according to the participants’ age.

Among those aged 51 or under, brushing teeth twice or three times a day lowered the risk of diabetes by 10% and 14%, respectively. This is compared to those who did so just once a day or not at all.

Gum disease raised the risk of the condition by 14% in this age group.

The younger participants with between one and seven missing teeth were 16% more at risk of diabetes.

In those aged 52 or older, no difference was found between those who brushed twice a day and those who did so just once or not at all.

Brushing at least three times a day, however, was linked to a 7% lower risk.

Gum disease also raised the older participants’ diabetes risk by 6%, while missing 15 or more teeth made them 34% more susceptible.

Oral health was found to particularly influence the women’s risk of diabetes.

The female participants who brushed their teeth three times a day were 15% less likely to develop diabetes, compared to a 5% risk reduction among the men.

Although unclear, poor oral hygiene may trigger the “invasion of oral bacteria and release of inflammatory mediators” that can result in insulin resistance.

A “driving factor that leads to type 2 diabetes”, this occurs when cells do not respond properly to insulin.

Tooth loss may also “provide easy access for the translocation of oral bacteria into the systemic circulation”.

https://sports.yahoo.com/brush-teeth-diabetes-oral-hygiene-230156645.html

FDA approves first triple combination pill for type 2 diabetes

From healio.com

The FDA on Monday approved the first oral therapy to combine three type 2 diabetes medications into one pill: the SGLT2 inhibitor empagliflozin, the DPP-IV inhibitor linagliptin and metformin hydrochloride extended release, according to a press release from Boehringer Ingelheim and Eli Lilly and Co.

The triple combination therapy (Trijardy XR) is approved to lower blood glucose for adults with type 2 diabetes along with diet and exercise.

“Many adults living with type 2 diabetes who are already on a treatment plan including multiple medications still struggle to keep their blood sugar under control, and may require additional agents to reach their [HbA1c] targets,” Ralph A. DeFronzo, MD, director of the diabetes research unit at the University of Texas Health Science Centre at San Antonio, said in the release. “Adding new medicines to an individual’s plan can be challenging for some, which is why new treatment options that can help improve blood sugar without the burden of an increased pill count are important. In addition, type 2 diabetes is a complex disease that often requires the use of multiple antidiabetic medications to improve glycaemic control. Having three different diabetes medications in a single tablet is an important advance in diabetes treatment.”

In the U.S., empagliflozin (Jardiance, Boehringer Ingelheim/Eli Lilly) and linagliptin (Tradjenta, Boehringer Ingelheim/Eli Lilly) are both once-daily tablets also approved to lower blood glucose for adults with type 2 diabetes. In 2016, the FDA approved a new indication for empagliflozin to reduce the risk for cardiovascular death among adult patients with type 2 diabetes and CVD. In June, the FDA granted fast track designation to empagliflozin for the reduction of risk for CV death and hospitalization for heart failure in people with chronic heart failure.

In findings from the CARMELINA trial presented at the American Diabetes Association Scientific Sessions in June and reported by Healio, researchers found that linagliptin did not increase risks for a new CV event or progression of renal disease among adults with type 2 diabetes, established CVD and renal impairment vs. placebo, regardless of age or the level of renal impairment. Additionally, a head-to-head comparison of the sulfonylurea glimepiride against linagliptin in a cohort of more than 6,000 adults with type 2 diabetes demonstrated no between-group differences for incidence of nonfatal myocardial infarction, nonfatal stroke and CV death during a median of 6 years, according to data from the CAROLINA trial, also reported at ADA.

https://www.healio.com/endocrinology/diabetes/news/online/%7B8ed9d16d-7185-431c-a413-f80bd53fdc68%7D/fda-approves-first-triple-combination-pill-for-type-2-diabetes