Key result
SGLT2 inhibitors best reduce HF and renal decline, while GLP-1 agonists superiorly cut ASCVD events.
Why the study?
Evidence regarding the mechanisms, clinical benefits, and roles of SGLT2 inhibitors and GLP-1 receptor agonists in cardiovascular prevention in type 2 diabetes mellitus remains scattered across the literature.
Do SGLT2 inhibitors and GLP-1 receptor agonists prevent cardiovascular complications in adult patients with type 2 diabetes mellitus?
Do SGLT2 inhibitors and GLP-1 receptor agonists prevent cardiovascular complications in adult patients with type 2 diabetes mellitus?
SGLT2 inhibitors and GLP-1 receptor agonists have complementary cardiorenal protective roles in type 2 diabetes, requiring individualized therapy selection based on specific patient cardiovascular risk profiles.
May guide risk-based selection of SGLT2 inhibitors versus GLP-1 agonists in type 2 diabetes; leaves open head-to-head trials on sequencing and combinations.
Type 2 diabetes mellitus is one of the leading causes of morbidity and mortality associated with cardiovascular complications. Advances in antihyperglycemic therapy have demonstrated that sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) not only improve glycemic control but also play an important role in preventing cardiovascular complications. However, evidence regarding their mechanisms of action, clinical benefits, and roles in cardiovascular prevention remains scattered across the literature. Objective of the research to review the current scientific evidence regarding the role of SGLT2 inhibitors and GLP-1 receptor agonists in preventing cardiovascular complications in patients with type 2 diabetes mellitus based on published studies. This study employed a narrative literature review using a systematic literature search approach. A literature search was conducted in the PubMed database for articles published between 2021 and 2026, following the PRISMA 2020 guidelines. A total of 15 eligible articles were included, comprising randomized controlled trials, cohort studies, observational studies, systematic reviews, meta-analyses, and post-hoc analyses. Results of the research showed that the synthesis of the included studies demonstrated that SGLT2 inhibitors consistently reduced the risk of hospitalization for heart failure, major adverse cardiovascular events (MACE), cardiovascular mortality, and the progression of chronic kidney disease. In contrast, GLP-1 receptor agonists were more effective in reducing atherosclerotic cardiovascular events through improvements in vascular function and metabolic risk factors. Several studies also suggested that combination therapy with both drug classes may provide greater cardiorenal benefits than monotherapy. SGLT2 inhibitors and GLP-1 receptor agonists have complementary roles in preventing cardiovascular complications in patients with type 2 diabetes mellitus. Therapeutic selection should be individualized according to patients' clinical characteristics and cardiovascular risk profiles to optimize cardiorenal outcomes.
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Anwar et al. (2026) conducted a review in Type 2 Diabetes Mellitus with high cardiovascular risk. SGLT2 inhibitors and GLP-1 receptor agonists was evaluated. SGLT2 inhibitors consistently reduce the risk of hospitalization for heart failure and kidney disease progression, while GLP-1 receptor agonists more effectively reduce atherosclerotic cardiovascular events in type 2 diabetes.
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