Purpose of Review
To evaluate the treatment of type 2 diabetes from a cardiologist’s view.
A new era in the treatment of type 2 diabetes began for the cardiologist in 2015 with the publication of the EMPA-REG outcome trial finding a significant reduction in CV death with empagliflozin (oral sodium-glucose co-transporter-2 [SGLT2] inhibitor) in patients with type 2 diabetes at increased cardiovascular risk. Shortly thereafter, the injectable glucagon-like peptide agonists (GLP-1) liraglutide and semaglutide found a significant reduction in composite major cardiovascular events (CV death, non-fatal MI, or stroke). Both classes have demonstrated significant renal protection when added to usual care. Moreover, there may be some exciting new benefits of SGLT2 inhibitors for patients with heart failure. These research studies are underway.
These two new classes of cardiovascular drugs for type 2 diabetes usher in a new era for the cardiologist who sees greater than 50% of patients with diabetes. The off-target effect of these agents is different as with all new cardiovascular compounds. While safety profiles in these populations are consistent with the known effects of these classes, new off-target effects have been seen with some agents in this class. Ongoing collaboration between cardiologists and other care providers remains important in the implementation of the evidence and care of patients with type 2 diabetes.
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Papers of particular interest, published recently, have been highlighted as: • Of importance
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Conflict of Interest
The authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
This article is part of the Topical Collection on Macrovascular Complications in Diabetes
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Chilton, R.J., Gallegos, K.M., Silva-Cardoso, J. et al. The Evolving Role of the Cardiologist in the Management of Type 2 Diabetes. Curr Diab Rep 18, 144 (2018). https://doi.org/10.1007/s11892-018-1114-1
- SGLT 2 inhibitors
- GLP-1 agonist
- Kidney protection
- Heart failure