Fig. 2.

Summary of ADA and KDIGO guidelines of use for glucose-lowering medication in people living with T2DM and CKD. Upper panel: ADA guidelines were abbreviated for specific treatment for people living with T2DM and CKD. Proven CVD benefit means it has label indication of reducing CVD events. For more context regarding glucose lowering medication in this population, refer to the Standards of Medical Care in Diabetes—2021 [15]. Lower panel: KDIGO recommend guidelines of glycemic management for people living with T2DM and CKD begin with lifestyle therapy followed by first-line pharmacological therapy with metformin and SGLT2i. For people contraindicated for SGLT2i, GLP-1 RAs are recommended. Additional drug therapy is guided by patient preferences, comorbidities, eGFR, and cost, and includes people with eGFR < 30 ml/min per 1.73 m² or those treated with dialysis [2]. *: Dapagliflozin; it is not recommended to initiate treatment with dapagliflozin in patients with GFR < 25 ml/min/1.73 m² [20, 21]. ADA American Diabetes Association, CV cardiovascular, CVOT cardiovascular outcome trial, DPP-4 dipeptidyl peptidase-4, eGFR estimated GFR, GLP-1 RA glucagon-like peptide-1 receptor antagonist, HbAc1 glycated hemoglobin, SGLT2i sodium-glucose cotransporter-2 inhibitor, T2DM type 2 diabetes mellitus, TZD thiazolidinediones. The figure was created by Lilly using the data from the American Diabetes Association [15] and Kidney Disease: Improving Global Outcomes Diabetes Work Group [2]. Permission is not required as only data were used