Type 2 Meds with Cardio Benefits

Dec 8, 2018

John S. is a 63-year-old white man with significant abdominal obesity, type 2 diabetes, hypertension, and dyslipidemia as well. On the basis of an exercise stress test, John was recently diagnosed with silent ischemia. John’s current medications include metformin, a DPP-4 inhibitor, an ACE inhibitor/HCTZ agent, a calcium channel blocker, a high-dose statin, and ezetimibe. John’s relevant physical exam and laboratory findings are as follows:

BMI	34.8 kg/m2
Blood pressure	140/86 mm Hg
HbA1C	7.2%
Total cholesterol	150 mg/dL
LDL-C	79 mg/dL
HDL-C	42 mg/dL
Triglycerides	145 mg/dL
non-HDL-C	118 mg/dL
eGFR	65 mL/min/1.73 m2
ACR	100 mg albumin/g creatinine

Which statement best describes the evidence supporting cardiovascular benefits of the antihyperglycemic agents available to treat John’s type 2 diabetes?

	A. Further glucose reduction using any available agent should have similar cardiovascular disease benefit.
	B. Thiazolidinediones increase the risk of heart failure and myocardial infarction in patients with type 2 diabetes.
	C. Two approved GLP-1 receptor agonists have been shown to reduce mortality in patients with type 2 diabetes and cardiovascular disease.
	D. Both GLP-1 receptor agonists and SGLT2 inhibitors affect cardiovascular risk through the same physiologic mechanisms.

Correct

Correct Answer is: C. Two approved GLP-1 receptor agonists have been shown to reduce mortality in patients with type 2 diabetes and cardiovascular disease.

Diabetes Spectrum 2017 Aug; 30(3): 202-210.https://doi.org/10.2337/ds16-0026

Incorrect