SGLT-2 Inhibitors vs. GLP-1 Receptor Agonists for Patients with Diabetes

Among the glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT-2) inhibitors, several drugs in each class have been shown to improve cardiac outcomes — myocardial infarction (MI), stroke, hospitalization for heart failure (HF), and cardiovascular-related mortality. Current guidelines recommend using either agent for patients with type 2 diabetes and cardiovascular disease (CVD; Diabetes Care 2021; 44:Suppl 1:S125). Using Medicare and two commercial insurance databases, investigators compared ≈180,000 propensity score–matched patients — stratified by CVD status — who initiated either an SGLT-2 inhibitor (i.e., canagliflozin, dapagliflozin or empagliflozin) or a GLP-1 receptor agonist (i.e., albiglutide, …