Guidelines for treating cardiovascular risk in patients with type 2 diabetes
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Major medical societies support use of GLP-1 RAs with proven CVD benefit1-5,a
2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes
2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
2022 Standards of Medical Care in Diabetes
Consensus Statement by the AACE/ACE on the Comprehensive Type 2 Diabetes Management Algorithm
aAccording to the ADA, “proven CVD benefit” means it has a label indication of reducing CVD events.1
GLP-1 RA=glucagon-like peptide-1 receptor agonist; CVD=cardiovascular disease; ADA=American Diabetes Association.
In patients with established ASCVD,b the use of a GLP-1 RA or SGLT-2i with demonstrated CVD benefita should be considered independently of baseline A1C or individual A1C target.1-5,c
A GLP-1 RA or SGLT-2i is recommended for initial therapy in patients with T2D with or at high risk for ASCVD regardless of treatment with metformin.1
bThe ACC defines ASCVD as: a history of an acute coronary syndrome or myocardial infarction (MI), stable or unstable angina, coronary heart disease with or without revascularization, other arterial revascularization, stroke, or peripheral artery disease assumed to be atherosclerotic in origin.2
cPlease refer to the 2022 ADA Standards of Medical Care in Diabetes, the 2020 AACE/ACE Consensus Statement, the 2020 AHA Scientific Statement on Cardiorenal Protection With the Newer Antidiabetic Agents, the 2020 ACC Expert Consensus Decision Pathway, or the 2021 AHA/ASA Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack.
ASCVD=atherosclerotic cardiovascular disease; SGLT-2i=sodium-glucose co-transporter-2 inhibitor; ACC=American College of Cardiology; AHA=American Heart Association; ASA=American Stroke Association.
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References:
- American Diabetes Association. Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S1-S264.
- Das SR, Everett BM, Birtcher KK, et al. 2020 Expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2020;76(9):1117-1145.
- Garber AJ, Handelsman Y, Grunberger G, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2020 Executive Summary. Endocr Pract. 2020;26(1):107-139.
- Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52(7):e364-e467.
- Rangaswami J, Bhalla V, de Boer IH, et al. Cardiorenal protection with the newer antidiabetic agents in patients with diabetes and chronic kidney disease: a scientific statement from the American Heart Association. Circulation. 2020;142(17):e265-e286.