Hormonal
GLP-1 receptor agonists (e.g., liraglutide, semaglutide) and SGLT2 inhibitors provide cardiovascular and renal benefits independent of glycemic control, with GLP-1 RAs being preferred for obesity/T2D and SGLT2 inhibitors for T2D with heart failure.
If you have T2D and obesity, ask your doctor about GLP-1 agonists (like Semaglutide or Liraglutide). They help with weight loss and protect your heart and kidneys, even if your blood sugar is already controlled. If you also have heart failure, SGLT2 inhibitors might be better.
In T2D and obesity, GLP-1 RA should be used as a preferred glucose-lowering treatment, whereas in patients with T2D, obesity and heart failure in cardiovascular disease SGLT2 inhibitors should be prioritized.
Why this rating
Based on multiple large-scale Cardiovascular Outcome Trials (EMPA-REG, LEADER) and meta-analyses.
Source
Management of obesity in the times of climate change and COVID-19: an interdisciplinary expert consensus report
Ewa Płaczkiewicz‐Jankowska et al. · Polskie Archiwum Medycyny Wewnętrznej · 2022
DOI 10.20452/pamw.16216
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Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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