CV Risk Management in Diabetes: A Mandate for GLP-1 Receptor Agonists?

Introduction/Overview

Lowering HbA1c Reduces the Risk of Microvascular Complications -- But What About Macrovascular Complications?

December 2008 FDA Guidance on Evaluating CV Risk in New Antidiabetic Therapies for T2DM

CVOTs in T2DM

What Explains the Macro- and Microvascular Improvements Observed in LEADER?

LEADER: Primary Outcome*

LEADER: Time to Composite Endpoint (Macroalbuminuria, Doubling of Serum Creatinine, ESRD, Renal Death)

LEADER Results: Hypoglycemia

SUSTAIN-6 (Semaglutide): Primary Outcome Results

ELIXA: Primary Outcome -- CV Death, Nonfatal MI, Nonfatal Stroke, or Hospitalization for Unstable Angina

EMPA-REG: Primary Outcome (3-point MACE) -- CV Death, Nonfatal MI, or Nonfatal Stroke

EMPA-REG: Hospitalization for HF

Potential Mechanisms for CV Benefit Associated With Empagliflozin

EMPA-REG Microvascular Outcomes: Renal Protection

Kidney Damage and SGLT2 Inhibitors

Combining GLP-1 RAs and SGLT2 Inhibitors: Different Mechanisms and Complimentary Outcomes?

CANVAS: Primary MACE Outcome

LEADER: AEs Leading to Permanent Treatment Discontinuation

Do Differences in Trials Explain Differences in Outcomes?

Explaining the Differences in CVOT Outcomes

Liraglutide Decreases Carotid IMT Independently of Its Effect on Plasma Glucose

When, and in Which Patients, Should These Newer Glucose-Lowering Agents Be Used: A Proviso

Safety Issues With Newer Glucose-Lowering Agents: CANVAS and Risk of Amputation

Renal Risk and Results of Treatment in T2DM

Treatment Guideline Updates

A Mandate for Newer Glucose-Lowering Agents?

Summary and Conclusions

Abbreviations

Abbreviations (cont)