The American College of Cardiology recommends SGLT2 inhibitors in patients with type 2 diabetes and established ASCVD, regardless of the patient's hemoglobin A1c. SGLT2 inhibitors have been shown to significantly reduce the risk for major adverse cardiovascular events, cardiovascular mortality, heart failure, and chronic kidney disease. In the EMPEROR-Reduced Clinical trial, empagliflozin was shown to reduce the risk for cardiovascular death by 38% and decline in glomerular filtration rate. This was later shown to be a class effect through the 2017 CANVAS trial; individuals who received canagliflozin experienced a 30% reduction in the risk for heart failure hospitalizations, cardiovascular death, and end-stage kidney disease.
DDP-4 inhibitors may be used in patients with renal impairment. However, uncertainties have been raised regarding heart failure risks.
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Cite this: Romesh Khardori, Anne L. Peters. Fast Five Quiz: Type 2 Diabetes Incretin-Based Therapy - Medscape - May 16, 2022.