Table 5.
Recommendations on the use of antidiabetic drugs
| Antidiabetic drugs choice | Population | Guideline | References |
|---|---|---|---|
| SGLT-2 inhibitor and /or GLP-1 RA | Patients with T2DM with established atherosclerotic CVD, or multiple risk factors for CVD or established kidney disease irrespective of additional glucose lowering and metformin use | ADA | [91] |
| SGLT-2 inhibitor | Patients with T2DM and established HFrEF | ||
| Initiated with metformin | Patients with T2DM and/or stable HF | ||
| Initiated with an SGLT-2 inhibitor or GLP-1 RA | Patients with newly diagnosed T2DM and established atherosclerotic CVD, or very high risk factors for CVD before metformin use | ESC/EASD | [40] |
| Initiated with metformin | Overweight patients with T2DM without CVD and at moderate CV risk | ||
| Metformin | In persons with T2DM with atherosclerotic CVD | ESC | [41] |
| Initiated with an SGLT-2 inhibitor or GLP-1 RA | In patients with T2DM without atherosclerotic CVD, HF, or chronic kidney disease | ||
| SGLT-2 inhibitor, GLP-1 agonists and metformin | Consistent with current ADA guideline | AHA | [39] |
DM diabetes mellitus, CVD cardiovascular disease, T2DM type 2 diabetes mellitus, ASCVD atherosclerotic cardiovascular disease, ADA American Diabetes Association, ESC European Society of Cardiology, EASD European Association for the Study of Diabetes, HF heart failure, SGLT-2 sodium-glucose cotransporter -2, GLP-1 RA glucagon-like peptide-1 receptor agonist, ACC American College of Cardiology