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Cardiorenal disease management in type 2 diabetes: An expert consensus

Viswanathan Mohan1, Awadhesh Kumar Singh2, Abdul Hamid Zargar3

  • 1Madras Diabetes Research Foundation & Dr.Mohan's Diabetes Specialities Centre, Chennai, India. Electronic address: http://www.drmohans.com.

Diabetes & Metabolic Syndrome
|November 14, 2022
PubMed

Insights

For type 2 diabetes (T2D), sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended for heart failure (HF) and chronic kidney disease (CKD). Glucagon-like peptide 1 (GLP-1) agonists are alternatives when SGLT2i are not tolerated.

Area of Science:

  • Endocrinology
  • Cardiology
  • Nephrology

Background:

  • The link between cardiovascular disease (CVD), chronic kidney disease (CKD), and type 2 diabetes (T2D) is well-established.
  • Managing T2D requires addressing heart failure (HF) and renal complications.

Purpose of the Study:

  • To provide expert opinions on preventing and treating HF and renal complications in T2D patients.
  • To offer evidence-based recommendations for managing comorbidities in T2D.

Main Methods:

  • Consensus recommendations developed by endocrinology, cardiology, and nephrology experts.
  • Statements required ≥80% agreement from specialized clinicians.
  • Opinions based on scientific evidence and clinical judgment.

Main Results:

  • Metformin plus lifestyle modification is the first-line T2D therapy.
  • Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are preferred for T2D with HF and CKD.
  • Glucagon-like peptide 1 (GLP-1) agonists are options for T2D with atherosclerotic cardiovascular disease (ASCVD) or high-risk indicators, or if SGLT2i are not tolerated.

Conclusions:

  • SGLT2i are preferred for T2D patients with HF or ASCVD.
  • SGLT2i and GLP-1 receptor agonists (GLP-1RA) reduce cardiovascular outcomes in T2D with ASCVD.
  • Treatment selection depends on individual patient profiles.
Abstract

Keywords:
CV risk AssessmentDapagliflozinGLP-1 agonistsIndian phenotypeSGLT2i

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