Cardiovascular disease and type 2 diabetes: Has the dawn of a new era arrived?

Muhammad Abdul-Ghani, Ralph A. DeFronzo, Stefano Del Prato, Robert Chilton, Rajvir Singh, Robert E.J. Ryder

Research output: Contribution to journalReview articlepeer-review

103 Scopus citations


Hyperglycemia is the major risk factor for microvascular complications in patients with type 2 diabetes (T2D). However, cardiovascular disease (CVD) is the principal cause of death, and lowering HbA1c has only a modest effect on reducing CVD risk andmortality. The recently published LEADER and SUSTAIN-6 trials demonstrate that, in T2D patients with high CVD risk, the glucagon-like peptide 1 receptor agonists liraglutide and semaglutide reduce the primary major adverse cardiac events (MACE) end point (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) by 13% and 24%, respectively. The EMPA-REG OUTCOME, IRIS (subjects without diabetes), and PROactive (second principal end point) studies also demonstrated a significant reduction in cardiovascular events in T2D patients treated with empagliflozin and pioglitazone. However, the benefit of these four antidiabetes agents (liraglutide, semaglutide, empagliflozin, and pioglitazone) on the three individual MACE end points differed, suggesting that different underlying mechanisms were responsible for the reduction in cardiovascular events. Since liraglutide, semaglutide, pioglitazone, and empagliflozin similarly lower the plasma glucose concentration but appear to reduce CVD risk by different mechanisms, there emerges the intriguing possibility that, if used in combination, the effects of these antidiabetes agents may be additive or even multiplicative with regard to cardiovascular benefit.

Original languageEnglish (US)
Pages (from-to)813-820
Number of pages8
JournalDiabetes care
Issue number7
StatePublished - Jul 1 2017

ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Cardiovascular disease and type 2 diabetes: Has the dawn of a new era arrived?'. Together they form a unique fingerprint.

Cite this