Reaching Consensus on Managing CVD Risk in Type 2 Diabetes

Melanie J. Davies, MD


June 09, 2021

Although first-line treatment of type 2 diabetes remains metformin plus lifestyle management, the majority of patients at diagnosis already have some form of cardiovascular disease (CVD).

The recent update to the Consensus Report by the American Diabetes Association and the European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes recognizes this and heralds a paradigm shift in patient management.

Experts, led by Professor Melanie Davies, from the University of Leicester in the United Kingdom, recommended that the decision to initiate therapy with a GLP-1 receptor agonist or SGLT2 inhibitor should be considered independently of either baseline or target A1c.

Here, Professor Davies discusses the use of these drugs in patients who have established CVD or are at high risk for CVD, heart failure, or chronic kidney disease, and how the addition of these drugs to metformin offers benefits beyond cardiorenal protection.

She also talks about the relative sequencing of GLP-1 receptor agonists and SGLT2 inhibitors, as well as the rationale for why they may be safely and effectively used together.


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