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Updated: Oct 29, 2025

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
Published on: February 28, 2013
Is time ready for combination therapy at diagnosis of type 2 diabetes?
Francesco Prattichizzo1, Antonio Ceriello1
1IRCCS MultiMedica, Milan, Italy.
Abstract:
Emerging evidence is showing a range of beneficial effects for GLP-1 receptor agonists and especially SGLT-2 inhibitors on the cardio-renal axis in patients with type 2 diabetes (T2D) and cardiovascular diseases (CVD). Preliminary findings suggest that: 1- such benefit extends also to patients with T2D without pre-existing CVD; and 2- background therapies do not modify the effect of these drugs. Given these considerations, some authors advanced the hypothesis that these novel agents might undermine the first-line position of metformin in the treatment algorithm of T2D. Here, we briefly discuss some pros and cons of such scenario, proposing a "starting" combination therapy with metformin plus one novel agent with trial-proven benefit as the best option to make use of the available knowledge and minimize the risk of complications in patients with newly diagnosed T2D.
Insights
Newer diabetes drugs like SGLT-2 inhibitors show cardio-renal benefits for type 2 diabetes (T2D) patients, even without prior cardiovascular disease (CVD). A combination therapy with metformin may be optimal for newly diagnosed T2D.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
- Pharmacology
Background:
- GLP-1 receptor agonists and SGLT-2 inhibitors demonstrate significant cardio-renal benefits in type 2 diabetes (T2D) patients with cardiovascular diseases (CVD).
- Emerging data suggest these benefits extend to T2D patients without pre-existing CVD.
- The efficacy of these novel agents is not altered by background therapies.
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