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- Title
Pharmacological treatment for Type 2 diabetes integrating findings from cardiovascular outcome trials: an expert consensus in the UK.
- Authors
Bain, S. C.; Bakhai, A.; Evans, M.; Green, A.; Menown, I.; Strain, W. D.
- Abstract
In people with Type 2 diabetes, cardiovascular disease is a leading cause of morbidity and mortality. Thus, as well as controlling glucose, reducing the risk of cardiovascular events is a key goal. The results of cardiovascular outcome trials have led to updates for many national and international guidelines. England, Wales and Northern Ireland remain exceptions, with the most recent update to the National Institute for Health and Care Excellence (NICE) guidelines published in 2015. We reviewed current national and international guidelines and recommendations on the management of people with Type 2 diabetes. This article shares our consensus on clinical recommendations for the use of sodium‐glucose co‐transporter 2 inhibitors (SGLT‐2is) and glucagon‐like peptide 1 receptor agonists (GLP‐1RAs) in people with Type 2 diabetes and established or at very high risk of cardiovascular disease in the UK. We also consider cost‐effectiveness for these therapies. We recommend considering each person's cardiovascular risk and using diabetes therapies with proven cardiovascular benefits when appropriate to improve long‐term outcomes and cost‐effectiveness. What's new?: Following positive cardiovascular outcome trial results, many national and international guidelines on the management of people with Type 2 diabetes have been updated for those also at high risk of cardiovascular disease. However, not all countries have updated their guidelines, notably England, Wales and Northern Ireland.This review shares a consensus on clinical recommendations for use of glucagon‐like peptide 1 receptor agonists and sodium–glucose co‐transporter 2 inhibitors in people with Type 2 diabetes.Although some countries have not yet updated their guidelines, we recommend consideration of each person's cardiovascular risk when selecting their diabetes therapy, to improve long‐term outcomes and cost‐effectiveness.
- Subjects
UNITED Kingdom; GLUCAGON-like peptide-1 agonists; SODIUM-glucose cotransporters; CARDIOVASCULAR diseases; CARDIOVASCULAR diseases risk factors; CONSENSUS (Social sciences); COST effectiveness; TYPE 2 diabetes; THERAPEUTICS
- Publication
Diabetic Medicine, 2019, Vol 36, Issue 9, p1063
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.14058