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SGLT2 inhibitors or GLP-1 receptor agonists as second-line therapy in type 2 diabetes: patient selection and

Holly E Gurgle1, Karen White1, Carrie McAdam-Marx1

  • 1Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA.

Vascular Health and Risk Management
|June 29, 2016
PubMed

Insights

For type 2 diabetes mellitus (T2DM) patients not controlled by metformin, this review compares glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors. It examines A1c reduction, weight loss, cardiovascular outcomes, and safety to guide treatment selection.

Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology
  • Clinical Medicine

Background:

  • Metformin is a first-line therapy for type 2 diabetes mellitus (T2DM).
  • Many patients require second-line therapy to achieve glycemic control.
  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2is) are newer pharmacologic options.

Purpose of the Study:

  • To compare the clinical trial and real-world effectiveness of GLP-1 RAs versus SGLT-2is in T2DM patients.
  • To evaluate key outcomes including A1c reduction, weight loss, cost-effectiveness, cardiovascular outcomes, and safety.

Main Methods:

  • Systematic review of clinical trial data.
  • Analysis of real-world effectiveness data.
  • Comparative assessment of GLP-1 RAs and SGLT-2is.

Main Results:

  • Both GLP-1 RAs and SGLT-2is demonstrate efficacy in A1c reduction and weight management.
  • Both drug classes have a low risk of hypoglycemia.
  • Comparative data on cardiovascular outcomes and cost-effectiveness are synthesized.

Conclusions:

  • GLP-1 RAs and SGLT-2is represent valuable second-line treatment options for T2DM.
  • Evidence supports informed selection based on individual patient profiles and desired outcomes.
  • Further comparative research may refine treatment guidelines.
Keywords:
A1cGLP-1 receptor agonistSGLT2 inhibitoradverse effecttype 2 diabetes mellitusweight loss

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