Guideline recommendations and the positioning of newer drugs in type 2 diabetes care

Marx, N., Davies, M. J., Grant, P. J., Mathieu, C., Petrie, J. R. , Cosentino, F. and Buse, J. B. (2021) Guideline recommendations and the positioning of newer drugs in type 2 diabetes care. Lancet Diabetes and Endocrinology, 9(1), pp. 46-52. (doi: 10.1016/S2213-8587(20)30343-0) (PMID:33159841)

Abstract

Cardiovascular outcome trials in patients with type 2 diabetes at high cardiovascular risk have led to remarkable advances in our understanding of the effectiveness of GLP-1 receptor agonists and SGLT2 inhibitors to reduce cardiorenal events. In 2019, the American Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), and European Society of Cardiology (ESC) published updated recommendations for the management of such patients. We are concerned that ongoing discussions focusing on the differences between the endocrinologists' consensus report from the ADA and EASD and cardiologists' guidelines from the ESC are contributing to clinical inertia, thereby effectively denying evidence-based treatments advocated by both groups to patients with type 2 diabetes and cardiorenal disease. A subset of members from the writing groups of the ADA–EASD consensus report and the ESC guidelines was convened to emphasise where commonalities exist and to propose an integrated framework that encompasses the views incorporated in management approaches proposed by the ESC and the ADA and EASD. Coordinated action is required to ensure that people with type 2 diabetes, cardiovascular disease, heart failure, or chronic kidney disease are treated appropriately with an SGLT2 inhibitor or GLP-1 receptor agonist. In our opinion, this course should be initiated independent of background therapy, current glycaemic control, or individualised treatment goals.

• Item Type: Articles
• Additional Information: NM’s work is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation; TRR 219; Project-ID 322900939 [M03, M05]). JRP’s work is supported by grants from JRDF (3-SRA-2019–669- M-B) and the UK Medical Research Council (related to NCT04007926). FC has received research grant support from the Swedish Research Council, the Swedish Heart–Lung Foundation, and the King Gustav V and Queen Victoria Foundation. JBB’s work is supported by grants from the US National Institutes of Health (UL1TR002489 and P30DK124723).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Petrie, Professor John
• Authors: Marx, N., Davies, M. J., Grant, P. J., Mathieu, C., Petrie, J. R., Cosentino, F., and Buse, J. B.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Lancet Diabetes and Endocrinology
• Publisher: Elsevier
• ISSN: 2213-8587
• ISSN (Online): 2213-8595
• Published Online: 04 November 2020
• Copyright Holders: Copyright © 2020 Elsevier
• First Published: First published in Lancet Diabetes and Endocrinology 9(1): 46-52
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher