Hormonal
In high-risk type 2 diabetes patients, GLP-1 receptor agonists and SGLT2 inhibitors reduce major adverse cardiovascular events (MACE), heart failure hospitalization, and chronic kidney disease progression independently of baseline HbA1c levels.
If you have type 2 diabetes and are at high risk for heart or kidney problems, ask your doctor about GLP-1 receptor agonists or SGLT2 inhibitors. These drugs protect your heart and kidneys regardless of your blood sugar levels. This is a key shift in treatment guidelines for high-risk patients.
the decision to treat with a GLP-1 receptor agonist or SGLT2 inhibitor to reduce MACE, hHF, CV death, or CKD progression should be considered independently of baseline HbA1c or individualized HbA1c target.
Why this rating
Based on large, multi-center cardiovascular outcomes trials (CVOTs) like REWIND, DECLARE-TIMI 58, and CREDENCE.
Source
2019 Update to: 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)
John B. Buse et al. · Diabetes Care · 2019
DOI 10.2337/dci19-0066
More from this paper
- SGLT2 inhibitors are recommended for type 2 diabetes patients with heart failure with reduced ejection fraction (HFrEF) to reduce hospitalization for heart failure, MACE, and cardiovascular death.Weak
- SGLT2 inhibitors are recommended for type 2 diabetes patients with chronic kidney disease (CKD) to prevent CKD progression, heart failure hospitalization, MACE, and cardiovascular death.Weak
- GLP-1 receptor agonists are recommended for type 2 diabetes patients with established atherosclerotic cardiovascular disease (ASCVD) to reduce MACE, with the strongest evidence for dulaglutide.Weak
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