Appropriate Use of SGLT2s and GLP-1 RAs With Insulin to Reduce CVD Risk in Patients With Diabetes (Archived)

Excerpt

Diabetes mellitus is a disease process that has been increasing globally and is estimated to affect more than 10% of adults in developed countries and 1 in 11 adults worldwide. Further estimations describe the total number of diabetes mellitus patients has quadrupled in the past 30 years. Diabetes mellitus is a chronic disease process that causes serious health consequences and increases the risk of developing health complications and comorbidities. Specifically, patients with diabetes are between two and four times more likely to develop a poor cardiovascular outcome than their non-diabetic counterparts.

In a study analyzing over 57 articles related to cardiovascular and diabetes outcomes, encompassing over 4.5 million people in various studies, researchers have found that cardiovascular disease affects an estimated 32.2% of those diagnosed with type 2 diabetes mellitus (T2DM) and contributes to over 50% of all deaths. Throughout the years, research has suggested that in addition to having diabetes well under control, mitigating risk factors associated with diabetes mellitus may decrease the likelihood of cardiovascular disease and adverse events in patients with diabetes. However, there is no set algorithm to achieve this target, and a patient-centered approach, evaluating their specific risk factors, is warranted. Choice of medical therapy should be individualized to obtain the best possible outcome for each patient. Initial treatment rests on educating the patient about glycemic control and appropriate lifestyle changes such as tobacco cessation, increasing exercise, and reducing body weight. However, patients with established cardiovascular disease or those at high risk of this disease warrant special consideration to prevent poor outcomes. This activity describes the evaluation and management of cardiovascular risks in patients with type 2 diabetes mellitus and emphasizes the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (also known as GLP-1RAs, GLP-1 receptor agonists, incretin mimetics, or GLP-1 analogs) drugs in conjunction with insulin to mitigate this risk.