Glucose-Lowering Drugs to Reduce Cardiovascular Risk in Type 2 Diabetes

This Clinical Practice article reviews glucose-lowering therapies in type 2 diabetes with a focus on reducing cardiovascular risk. The author presents a vignette of a 64-year-old woman with a history of myocardial infarction and suboptimal glycemic control (HbA1c 7.9%) on metformin. Emphasis is placed on individualized glycemic targets—typically <6.5% or <7.0% alongside risk factor reduction. Lifestyle management and cardiovascular assessment guide therapy intensification. In patients with established cardiovascular disease or high-risk features, guidelines recommend glucose-lowering drugs with proven cardiovascular benefit: GLP-1 receptor agonists (e.g., liraglutide, semaglutide, dulaglutide) and SGLT2 inhibitors (e.g., empagliflozin, canagliflozin, dapagliflozin). These agents have shown benefit in major cardiovascular events, heart failure, and renal outcomes. Tables outline efficacy, mechanisms, and adverse effects for injectable and oral agents

This Clinical Practice article reviews glucose-lowering therapies in type 2 diabetes with a focus on reducing cardiovascular risk. The author presents a vignette of a 64-year-old woman with a history of myocardial infarction and suboptimal glycemic control (HbA1c 7.9%) on metformin. Emphasis is placed on individualized glycemic targets—typically <6.5% or <7.0% alongside risk factor reduction. Lifestyle management and cardiovascular assessment guide therapy intensification. In patients with established cardiovascular disease or high-risk features, guidelines recommend glucose-lowering drugs with proven cardiovascular benefit: GLP-1 receptor agonists (e.g., liraglutide, semaglutide, dulaglutide) and SGLT2 inhibitors (e.g., empagliflozin, canagliflozin, dapagliflozin). These agents have shown benefit in major cardiovascular events, heart failure, and renal outcomes. Tables outline efficacy, mechanisms, and adverse effects for injectable and oral agents