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Cardiovascular outcome trials of glucose-lowering therapies

journal contribution
posted on 15.05.2020, 10:52 by Kamlesh Khunti, Melanie J Davies, Samuel Seidu

Introduction: Early initiated and long-term sustained intensive glucose control is associated with a significantly decreased risk of cardiovascular events and all-cause mortality, over and above the well-established decline in the risk of microvascular disease. Based on the recent cardiovascular outcome trial (CVOT) data, this review focuses on the various benefits of the newer medications with their positioning in the treatment algorithm and explores the place of the older medications in the management of type 2 diabetes mellitus (T2DM).

Areas covered: We searched the literature for glucose lowering therapies for patients with T2DM. We included CVOTs conducted for newer sulphonylureas, thiazolidinediones, insulin degludec, DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists.

Expert opinion: Selection of glucose-lowering therapy in the management of T2DM should be individualized and based on patient characteristics, associated comorbidities, patient preference, affordability and adherence to treatment. In view of the benefits seen in the CVOTs with SGLT2 inhibitors and GLP-1 receptor agonists, these newer classes should be the preferred choice in patients with/without established atherosclerotic cardiovascular disease and chronic kidney disease.

History

Citation

Expert Review of Pharmacoeconomics & Outcomes Research, 2020, In Press

Version

AM (Accepted Manuscript)

Published in

Expert Review of Pharmacoeconomics & Outcomes Research

Pagination

1 - 13

Publisher

Informa UK Limited

issn

1473-7167

eissn

1744-8379

Copyright date

2020

Publisher version

TBA

Language

en