Glucose-lowering drugs or strategies, atherosclerotic cardiovascular events, and heart failure in people with or at risk of type 2 diabetes: an updated systematic review and meta-analysis of randomised cardiovascular outcome trials

Review (30 trials; n=225,305) found glucose-lowering drugs or strategies overall reduced risk of fatal and non-fatal atherosclerotic events compared with standard care or placebo (RR 0.92, 95% CI 0·89–0·95, p<0·0001); the effect on heart failure was neutral overall.

SPS commentary:

A commentary notes this updated meta-analysis once more establishes GLP-1 receptor agonists and SGLT2 inhibitors as disease-modifying drugs, but regrettably, many aspects of diabetes treatment remain unresolved: should these drugs be used early in the course of the disease and why are the positive effects observed on the heart, brain, and kidney not also seen in the retina, peripheral circulation, and nervous system? It suggests that these unknowns dampen the enthusiasm for the findings of this systematic review.


The Lancet Diabetes & Endocrinology

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