Hormonal
SGLT-2 inhibitors are superior to GLP-1 receptor agonists for reducing hospital admissions for heart failure, while GLP-1 receptor agonists are superior for reducing non-fatal stroke.
Choose your diabetes drug based on your specific health history, not just blood sugar. If you have heart failure, an SGLT-2 inhibitor offers superior protection. If you have a history of stroke, a GLP-1 agonist is likely the better option. Ask your doctor which class aligns with your specific risks.
Notable differences were found between the two agents: SGLT-2 inhibitors reduced mortality and admission to hospital for heart failure more than GLP-1 receptor agonists, and GLP-1 receptor agonists reduced non-fatal stroke more than SGLT-2 inhibitors (which appeared to have no effect).
Why this rating
High certainty evidence for heart failure and moderate/high for stroke.
Source
Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials
Suetonia C. Palmer et al. · BMJ · 2021
DOI 10.1136/bmj.m4573
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