Cardiovascular Safety of SGLT2 Inhibitors Compared to DPP4 Inhibitors and Sulfonylureas as the Second Line of Therapy in T2DM Using Large, Real-World Clinical Data in Korea
The most updated guidelines recommend SGLT2 inhibitors as the preferred option for patients with established ASCVD or indicators of high ASCVD risk, chronic kidney disease (CKD), and heart failure (HF). But without solid evidence, the choice of a second-line therapy to add to metformin is not yet prioritized, it is considered as per the clinical profiles of individual patients. Kyuho Kim and colleague published an editorial in the Diabetes Metabolism Journal under the title “Cardiovascular Safety of SGLT2 Inhibitors Compared to DPP4 Inhibitors and Sulfonylureas as the Second Line of Therapy in T2DM Using Large, Real-World Clinical Data in Korea”. The summary of this editorial is given below:
Objective:
To compare cardiovascular safety of SGLT2 Inhibitors with DPP4 Inhibitors and Sulfonylureas as a Second Line of Therapy in T2DM.
Method:
Researches published studying cardiovascular safety of SGLT2 Inhibitors, DPP4 Inhibitors, and Sulfonylureas are selected. The available data is then compared by a team of medical experts and researchers.
Finding:
Authors suggest that the beneficial effect of SGLT2 inhibitors on cardiovascular composite outcomes can be expected in TYPE 2 diabetes patients belonging to the general population. Considering the low risk of hypoglycemia, beneficial effect on weight as well as cardiovascular and renal outcome, and similar glucose-lowering efficacy compared with other oral hypoglycemic agents, it can be concluded that SGLT2 inhibitors can be given a priority as second-line therapy after metformin monotherapy in patients with type 2 diabetes mellitus in the future, in particular over ASCVD or CKD predominates.
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