RESUMO
The sodium glucose co-transporter 2 (SGLT2) inhibitor empagliflozin is currently funded in New Zealand for management of patients with type 2 diabetes who have an HbA1c >53mmol/mol and a high cardiovascular (CV) risk. Large clinical trials now provide strong evidence that SGLT2 inhibitors decrease the risk of cardiovascular death, heart failure, progressive kidney dysfunction, myocardial infarction, stroke and gout. Patients with or without diabetes who have a history of heart failure, including those with a preserved left ventricular ejection fraction and patients with chronic kidney impairment are likely to benefit most from treatment with an SGLT2 inhibitor. These findings make a strong case for extending funding of SGLT2 inhibitors to include patients with heart failure or kidney dysfunction without diabetes, so many more New Zealanders could benefit.
Assuntos
Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Inibidores do Transportador 2 de Sódio-Glicose , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucose/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Nova Zelândia , Sódio , Transportador 2 de Glucose-Sódio/uso terapêutico , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Volume Sistólico , Função Ventricular EsquerdaAssuntos
Saúde do Adolescente , Saúde da Criança , Política de Saúde , Saúde Mental , Adolescente , Criança , Cultura , Feminino , Hong Kong , Humanos , Masculino , Comportamento Problema , Estresse Psicológico/psicologiaAssuntos
Serviços de Saúde da Criança/normas , Proteção da Criança/tendências , Saúde Global , Adolescente , Criança , Cuidado da Criança/normas , Cuidado da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Política de Saúde , Humanos , Programas de Imunização , Lactente , Recém-Nascido , Cooperação Internacional , MasculinoRESUMO
There has been increasing awareness over recent years of the persisting burden of worldwide maternal, newborn, and child mortality. The majority of maternal deaths occur during labor, delivery, and the immediate postpartum period, with obstetric hemorrhage as the primary medical cause of death. Other causes of maternal mortality include hypertensive diseases, sepsis/infections, obstructed labor, and abortion-related complications. Recent estimates indicate that in 2009 an estimated 3.3 million babies died in the first month of life and that overall, 7.3 million children under 5 die each year. Recent data also suggest that sufficient evidence- and consensus-based interventions exist to address reproductive, maternal, newborn, and child health globally, and if implemented at scale, these have the potential to reduce morbidity and mortality. There is an urgent need to put elements in place to promote integrated interventions among healthcare professionals and their associations. What is needed is the political will and partnerships to implement evidence-based interventions at scale.
