Large randomized controlled trials have reported statistically significant reductions in cardiovascular events among patients receiving GLP-1 receptor agonists (liraglutide, semaglutide, and dulaglutide) and for those receiving the SGLT2 inhibitors empagliflozin, canagliflozin, and dapagliflozin.
Cardiovascular outcomes trials of DPP-4 inhibitors have not shown cardiovascular benefits relative to placebo.
The ADA recently updated its guidelines to include consideration of atherosclerotic cardiovascular disease and kidney disease when choosing glucose-lowering therapies. Specifically:
In patients with T2D who have established atherosclerotic cardiovascular disease or established kidney disease, an SGLT2 inhibitor and/or GLP-1 receptor agonist with demonstrated cardiovascular disease benefit is recommended as part of the comprehensive cardiovascular risk reduction and/or glucose-lowering regimen
In patients with T2D and established atherosclerotic cardiovascular disease or established kidney disease, an SGLT2 inhibitor and/or GLP-1 receptor agonist with demonstrated cardiovascular benefit is recommended to decrease the risk for major adverse cardiovascular events
DPP-4 inhibitors may lead to worsening heart failure in patients with established CVD or metabolic abnormalities.
Learn more about pharmacologic therapy for CVD risk reduction in patients with T2D.
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Cite this: Romesh Khardori. Fast Five Quiz: Type 2 Diabetes and Cardiovascular Disease Risk - Medscape - Feb 15, 2022.