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.
Management of Type 2 Diabetes Consensus Guidelines (ADA and EASD, 2018): American Diabetes Association and the European Association for the Study of Diabetes
Cardiovascular Disease Prevention and Management Clinical Practice Guidelines (2018): Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE)
Cardiovascular Disease Primary Prevention/Lifestyle Guidelines
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Cite this: Romesh Khardori. Fast Five Quiz: Type 2 Diabetes and Cardiovascular Disease Risk - Medscape - Feb 15, 2022.