Glucose-Lowering Medication Classes and Cardiovascular Outcomes in Patients With Type 2 Diabetes

Do sustained treatments with 4 classes of glucose-lowering medications have differential effects on major adverse cardiovascular events (MACEs) in US adults with type 2 diabetes (T2D)?In this comparative effectiveness study of 296 676 US adults with T2D, MACEs varied significantly across 4 classes of glucose-lowering medications: sustained treatment with GLP-1RAs was most protective against MACEs followed by SGLT2is, sulfonylureas, and DPP4is. The benefit of GLP-1RAs over SGLT2is varied in magnitude across subgroups defined by baseline age, atherosclerotic cardiovascular disease, heart failure, and kidney impairment.These findings may help inform clinician and patient selection of glucose-lowering medications to treat T2D when the goal is to optimize cardiovascular outcomes.

Corresponding Author: Romain Neugebauer, PhD, Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Dr, Pleasanton, CA 94588 (romain.s.neugebauer@kp.org).

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