How Do the Recent Major Randomized Controlled Trials Inform Best Use of the Novel Glucose-Lowering Agents?

Abstract

Background: Type 2 diabetes mellitus (T2DM) is frequently associated with the development of cardiovascular disease and chronic kidney disease (CKD). Some newer glucose-lowering agents confer both cardiac and kidney benefits, as supported by robust data from recent high-quality randomized controlled trials. The decision-making process when selecting glucose-lowering medications for T2DM now extends beyond glycaemia and metabolic effects, and towards additional benefits such as prevention of other complications. Summary: We review the evidence for efficacy in 3 new classes of medication for T2DM and additionally discuss relevant safety issues when considering optimal agents. Key Messages: Clinicians have multiple efficacy and safety factors to consider when selecting agents for glucose lowering in T2DM, and this should help direct individualized selection of pharmacotherapy for patients. New medications offer an opportunity to prevent cardiac and renal complications in people with T2DM.

Keywords

• type 2 diabetes
• cardiovascular disease
• sodium-glucose co-transporter 2 inhibitors
• glucagon-like peptide-1 receptor agonists