Page 202 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology Medication therapy based on HbA1c

established it to be an important predictor of diastolic T2DM in patients with IHD. It was incorporated into the
dysfunction in patients with T2DM. treatment standards in Uzbekistan in 2018. Consequently,
the duration of observation for patients using empagliflozin
4.2. Implications for clinical practice was significantly limited.

The results of this study have significant implications
for clinical practice. Lowering HbA1c levels below 5. Conclusion
the threshold is substantial for mitigating the risk of This study investigated the prescribed basic medication
cardiovascular complications in patients with T2DM therapy in relation to achieving target HbA1c levels in
and IHD. Healthcare providers should consider patients with T2DM and IHD. The findings revealed
individualized treatment approaches based on patient significant differences in demographic characteristics,
characteristics, disease duration, and glycemic control. duration of diabetes and IHD, and medication usage
The use of medications with cardiovascular benefits, such between patients who achieved target HbA1c levels
as empagliflozin, should be prioritized in patients who (≤8%) and those who did not (≥8%). Reaching target
achieve target levels of HbA1c. levels of HbA1c is important for mitigating the risk of
The UKPDS demonstrated that intensive blood-glucose cardiovascular complications.
control significantly reduces the risk of cardiovascular Patients with higher HbA1c levels had a longer
events in patients with T2DM. The Action to Control duration of diabetes and IHD. Female patients with
Cardiovascular Risk in Diabetes study further emphasized higher levels of HbA1c were older than male patients who
the importance of maintaining optimal glycemic control to did not reach target levels. These patients required more
improve cardiovascular outcomes.
aggressive antihyperglycemic therapy, including higher
Recent advancements in diabetes treatment have usage of metformin and insulin. The use of cardiovascular
introduced new classes of antihyperglycemic agents, such medications varied significantly between the groups, with
as GLP-1 receptor agonists and SGLT2 inhibitors, which higher usage of ACE inhibitors and statins in patients with
have demonstrated better results in improving both higher HbA1c levels.
glycemic control and cardiovascular outcomes. Joseph
et al. discussed management strategies for cardiovascular Our logistic regression model demonstrated a very
6
risk factors in adults with T2DM, underscoring the need high receiver operating characteristic area under the curve
for individualized treatment approaches. Johnson and value of 0.92 on the test set, effectively predicting whether
Wang and Smith and Patel concluded that the combined the patient would achieve target HbA1c levels after
7
26
use of these medications provides better cardiometabolic treatment. In addition, the linear regression model was
and renal outcomes than monotherapy. used to analyze the efficiency of hypoglycemic medications
and their combination based on patients’ data, yielding a
4.3. Limitations Spearman’s correlation coefficient of 0.82 on the test set.
This study has several limitations that should be Acknowledgments
considered when interpreting its findings. The sample
size was relatively small, and the study was conducted at a None.
single center. Moreover, the patients in this study originate
from various regions across the country, as the center Funding
serves as the primary cardiologic hospital in Uzbekistan. None.
In addition, the observational nature of the study does
not allow causal inferences to be made. The high costs of Conflict of interest
repeated laboratory tests constrained the frequency and The authors declare they have no competing interests
scope of data collection.
Further limitations include potential confounding Author contributions
factors, such as patients’ adherence, socioeconomic factors, Conceptualization: Raisa Trigulova, Alisher Ikramov
dietary adherence, and stress. A more comprehensive Formal analysis: Shukhrat Doniyorov
analysis is required to account for these factors. However, Investigation: Dilnoza Alimova, Shakhnoza Mukhtarova
the use of empagliflozin was well-monitored, as this Methodology: Dilafruz Akhmedova
medication was provided to patients by the center. Writing – original draft: Raisa Trigulova
Empagliflozin was relatively recently approved by Writing – review & editing: Raisa Trigulova, Alisher
the Food and Drug Administration for the treatment of Ikramov

Volume 9 Issue 3 (2025) 194 doi: 10.36922/EJMO025160133