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Emerging glucose-lowering therapies: a guide for cardiologists
Gaurav S Gulsin1, Matthew P M Graham-Brown1, Melanie J Davies2
1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Heart (British Cardiac Society)
|September 26, 2019
Summary
Sodium glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) show cardiovascular benefits in type 2 diabetes mellitus (T2DM). These agents are increasingly recommended for managing T2DM and preventing cardiovascular disease.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Type 2 diabetes mellitus (T2DM) is highly prevalent in patients with cardiovascular disease.
- New glucose-lowering medications, SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1RAs), demonstrate significant cardiovascular benefits.
- These agents are increasingly incorporated into clinical guidelines for T2DM management.
Purpose of the Study:
- To review cardiovascular outcome trial evidence for SGLT2i and GLP-1RAs in T2DM.
- To provide practical prescribing advice and safety considerations for these medications.
- To highlight ongoing research and future directions in the use of SGLT2i and GLP-1RAs for cardiovascular risk reduction in T2DM.
Main Methods:
- Systematic review of large-scale cardiovascular outcome trials involving SGLT2i and GLP-1RAs.
- Analysis of current European and US treatment guidelines.
- Summary of safety profiles and clinical trial data.
Main Results:
- SGLT2i and GLP-1RAs have demonstrated substantial cardiovascular benefits in adults with T2DM.
- These drug classes are recommended as second-line therapy for glycemic control and cardiovascular risk reduction.
- Evidence supports their role in managing T2DM patients with established cardiovascular disease.
Conclusions:
- SGLT2i and GLP-1RAs represent a significant advancement in managing cardiovascular risk in T2DM.
- Cardiologists will increasingly encounter and need to be familiar with these agents.
- Further research is ongoing to define optimal use and long-term outcomes.
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