Recommended advanced treatment for patients with diabetes, identified by grade of evidence
| TREATMENT | ESTABLISHED DISEASE | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ATHEROSCLEROTIC CARDIOVASCULAR DISEASE | CHRONIC KIDNEY DISEASE | HEART FAILURE | RISK FACTORS* | |||||||||
| OUTCOME | OUTCOME | OUTCOME | OUTCOME | |||||||||
| MACE | HHF | NEPHRO | MACE | HHF | NEPHRO | MACE | HHF | NEPHRO | MACE | HHF | NEPHRO | |
| SGLT2I | ||||||||||||
| • Empagliflozin | A | B | B | C | A | A | A | |||||
| • Canagliflozin | B | B | B | B | A | A | A | B | C | |||
| • Dapagliflozin | B | B | A | A | A | B | C | |||||
| GLP1-RA | ||||||||||||
| • Semaglutide SC | B | B | C | |||||||||
| • Liraglutide | A | B | B | |||||||||
| • Dulaglutide | A | A | ||||||||||
GLP1-RA—glucagonlike peptide-1 receptor agonist, HHF—hospitalization for heart failure, MACE—major cardiovascular event, NEPHRO—progression of nephropathy, SC—subcutaneous, SGLT2I—sodium-glucose co-transporter-2 inhibitor.
↵*Risk factors include smoking, hypertension, dyslipidemia, and central obesity.
Recommendations from Diabetes Canada1 and the American Diabetes Association.2