Hormonal
For patients with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD), sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists with proven cardiovascular benefit are recommended as part of glycemic management, regardless of baseline HbA1c.
If you have type 2 diabetes and a history of heart disease (like a heart attack or stroke), your doctor should prioritize medications that protect your heart, specifically SGLT2 inhibitors (like empagliflozin) or GLP-1 agonists (like liraglutide), even if your blood sugar is already reasonably controlled. This is a major shift from older guidelines that focused only on lowering blood sugar numbers.
Among patients with type 2 diabetes who have established ASCVD, SGLT2 inhibitors or GLP-1 receptor agonists with proven cardiovascular benefit are recommended as part of glycemic management (Figs. 2 and 3).
Why this rating
Based on large, multi-year cardiovascular outcomes trials (CVOTs) demonstrating statistical superiority for major adverse cardiac events (MACE) and mortality.
Source
Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
Melanie J. Davies et al. · Diabetes Care · 2018
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