Research
Hormonal
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.
If you have type 2 diabetes and established cardiovascular disease, ask your doctor about GLP-1 receptor agonists. These drugs are proven to reduce major adverse cardiovascular events, offering protection beyond blood sugar control.
WeakSupportsHIGH confidence
For patients with type 2 diabetes and established atherosclerotic CV disease... where MACE is the gravest threat, the level of evidence for MACE benefit is greatest for GLP-1 receptor agonists.
Why this rating
Based on REWIND and other CVOTs.
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
clinical_guidelineCited 1,186×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- 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.Weak
- 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
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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