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. Author manuscript; available in PMC: 2020 Oct 15.
Published in final edited form as: J Am Coll Cardiol. 2018 Nov 26;72(24):3200–3223. doi: 10.1016/j.jacc.2018.09.020

FIGURE 2. Approach to Managing Patients With Established ASCVD and T2D.

FIGURE 2

*SGLT2 inhibitors and GLP-1RA have not been studied in and do not have an FDA -approved indication for patients with type 1 diabetes.

†Some cardiovascular outcome trials included primary prevention patients with multiple risk factors for ASCVD.

‡ The available evidence for cardiovascular event reduction in patients with T2D and clinical ASCVD is derived from trials in which most participants were treated with metformin at baseline. Please see “Do Patients Need to Be on Metformin Before Initiating an SGLT2 Inhibitor or a GLP-1RA?” section in text.

**Please see Table 12 and Table 13. If A1C well-controlled at baseline, or known history of frequent hypoglycemic events, reduce dose of sulfonylurea by 50% or basal insulin dose by 20% when starting therapy.

Abbreviations:

ASCVD = atherosclerotic cardiovascular disease; ESRD = end-stage renal disease; FDA = Food and Drug Administration; GLP-1RA = glucagon-like peptide-1 receptor agonist; SGLT2 = sodium-glucose cotransporter-2; T2D = type 2 diabetes; y/o = years old