The September 14, 2021 session of Duke Medicine LEADS was presented by Susan Spratt, MD on "SGLT2 inhibitors for Diabetes: A Compelling Story."
Here are pearls and takeaways from the session:
- SGLT2 inhibitors work on the sodium glucose co-transporter in the proximal tubule of the kidney to promote the renal excretion of glucose and lower elevated blood glucose in patients with diabetes independent of insulin and do not typically cause hypoglycemia.
- SGLT2 inhibitors have been shown in several trials (EMPA-REG, CANVAS, DECLARE-TIMI 58, and CREDENCE) to have significant reduction in major adverse cardiovascular events in patients with type 2 diabetes mellitus and pre-existing cardiovascular disease or heart failure.
- If your patient has coronary disease, prior MI, heart failure or chronic kidney disease, then they have a compelling indication to start on GLP-1 or SGLT2 inhibitor. The choice is not always clear which to start and is often a case-by-case basis. GLP-1 may be used first in pure atherosclerotic cardiovascular disease, however require weekly injections. SGLT2 inhibitors do have more benefit in heart failure or renal dysfunction.
- For many with type 2 diabetes and high CV risk, trying to get on both SGLT2 inhibitor and GLP-1 would be most beneficial
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.