SGLT-2 inhibitors or GLP-1 receptor agonists use in type 2 diabetes: Expert Guidelines

Written by Medha Baranwal Published On 2021-05-13T19:00:39+05:30 | Updated On 2021-05-13T19:05:43+05:30

SGLT-2 inhibitors or GLP-1 receptor agonists use in type 2 diabetes: Expert Guidelines

Delhi: An international panel including patients, clinicians, and methodologies has released risk-stratified recommendations concerning the use of SGLT-2 inhibitors or GLP-1 receptor agonists in adults with type 2 diabetes. Clinical decisions about the treatment of type 2 diabetes have been led by glycaemic control for decades. SGLT-2 inhibitors and GLP-1 receptor agonists are...

Clinical decisions about the treatment of type 2 diabetes have been led by glycaemic control for decades. SGLT-2 inhibitors and GLP-1 receptor agonists are traditionally used in people with elevated glucose levels after metformin treatment. This has changed through trials demonstrating atherosclerotic cardiovascular disease (CVD) and chronic kidney disease (CKD) benefits independent of medications' glucose-lowering potential.

The recommendations were based on the results from a linked systematic review and network meta-analysis (764 randomized trials included 421 346 participants) of benefits and harms.

The guideline panel issued risk-stratified recommendations concerning the use of SGLT-2 inhibitors or GLP-1 receptor agonists in adults with type 2 diabetes

Three or fewer cardiovascular risk factors without established CVD or CKD: Weak recommendation against starting SGLT-2 inhibitors or GLP-1 receptor agonists.
More than three cardiovascular risk factors without established CVD or CKD: Weak recommendation for starting SGLT-2 inhibitors and weak against starting GLP-1 receptor agonists.
Established CVD or CKD: Weak recommendation for starting SGLT-2 inhibitors and GLP-1 receptor agonists.
Established CVD and CKD: Strong recommendation for starting SGLT-2 inhibitors and weak recommendation for starting GLP-1 receptor agonists.
For those committed to further reducing their risk for CVD and CKD outcomes: Weak recommendation for starting SGLT-2 inhibitors rather than GLP-1 receptor agonists.

About SGLT-2 inhibitors and GLP-1 receptor agonists

Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are a class of oral anti-diabetic drugs, including empagliflozin, canagliflozin, dapagliflozin, and ertugliflozin. They increase the excretion of glucose and sodium in the urine by inhibiting SGLT-2 in the kidney, thus lowering the blood glucose level. They may also slightly lower blood pressure and body weight.

Glucagon-like peptide 1 (GLP-1) receptor agonists are a class of non-insulin injection anti-diabetic drugs, including exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, semaglutide, and loxenatide. They mimic the intestinal hormone incretin and bind its receptor, which slows the rate at which food leaves the stomach, controls the appetite, and regulates insulin and glucagon secretion.

Reference:

"SGLT-2 inhibitors or GLP-1 receptor agonists for adults with type 2 diabetes: a clinical practice guideline," is published in the BMJ.

DOI: https://www.bmj.com/content/373/bmj.n1091

Source : BMJ

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751