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Cardiovascular outcome trials of glucose-lowering therapies

Kamlesh Khunti1, Melanie J Davies1, Samuel Seidu1

  • 1Diabetes Research Centre, Leicester General Hospital, University of Leicester , Leicester, UK.

Expert Review of Pharmacoeconomics & Outcomes Research
|May 15, 2020
PubMed
Abstract

Insights

Intensive glucose control in type 2 diabetes mellitus (T2DM) reduces cardiovascular events. Newer medications like SGLT2 inhibitors and GLP-1 receptor agonists offer significant benefits and should be prioritized.

Area of Science:

  • Endocrinology
  • Cardiology
  • Nephrology

Background:

  • Intensive glucose control in type 2 diabetes mellitus (T2DM) significantly reduces cardiovascular events and mortality.
  • This benefit extends beyond the known reduction in microvascular disease risk.

Purpose of the Study:

  • Review the benefits of newer glucose-lowering medications based on cardiovascular outcome trial (CVOT) data.
  • Define the optimal positioning of these newer agents within T2DM treatment algorithms.
  • Evaluate the role of older medications in current T2DM management.

Main Methods:

  • Literature search for glucose-lowering therapies in T2DM.
  • Inclusion of cardiovascular outcome trials (CVOTs) for various drug classes.
  • Focus on newer agents including SGLT2 inhibitors and GLP-1 receptor agonists.

Main Results:

  • Newer medications, particularly SGLT2 inhibitors and GLP-1 receptor agonists, demonstrate significant cardiovascular benefits in CVOTs.
  • These agents offer advantages beyond glycemic control, impacting cardiovascular and renal outcomes.
  • Older medications may have a diminished role compared to newer agents with proven CVOT benefits.

Conclusions:

  • Individualized selection of T2DM therapy is crucial, considering patient factors, comorbidities, and preferences.
  • SGLT2 inhibitors and GLP-1 receptor agonists are preferred choices for patients with or without established cardiovascular disease and chronic kidney disease.
  • These newer classes represent a significant advancement in T2DM management, prioritizing cardiovascular and renal protection.
Keywords:
Cardiovascular outcome trialsglucose lowering therapiesmajor adverse cardiovascular eventstype 2 diabetes

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