Use of Antidiabetic Drugs In Cardiovascular Therapy

Abstract

The thesis discusses the cardiovascular effects of antidiabetic drugs and their increasing importance beyond glucose control. The review discusses the mechanisms of cardiovascular and renal protection and the evidence from major cardiovascular outcome trials of SGLT2 inhibitors, GLP-1 receptor agonists and metformin. Results SGLT2 inhibitors are effective in preventing heart failure and CKD, whereas GLP-1 receptor agonists are particularly effective in reducing atherosclerotic cardiovascular risk and obesity-related risk. Other drug classes such as DPP-4 inhibitors, TZDs, and insulin secretagogues are more limited in their cardiovascular roles based on neutral outcomes or safety concerns. To summarize, the thesis highlights that the cardiovascular and renal phenotype and the overall risk of the patient should guide the choice of antidiabetic therapy and not just glucose control.