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A new study indicates that combining sodium-glucose co-transporter 2 inhibitors (SGLT2is) with glucagon-like peptide-1 receptor agonists (GLP-1RAs) can significantly reduce the risk of heart and kidney disease in diabetic patients. Published in The Lancet Diabetes & Endocrinology, the study’s findings highlight a promising therapeutic strategy for diabetes management.
Mechanisms of Action
SGLT2 inhibitors, also known as gliflozins, help lower blood glucose levels by promoting its excretion through urine. On the other hand, GLP-1 receptor agonists, such as Ozempic, enhance insulin release and improve insulin sensitivity. Both drug classes target different aspects of diabetes management, offering a complementary approach.
Study Insights
Led by Clinical Associate Professor Brendon Neuen from The George Institute for Global Health, the study conducted a meta-analysis of 12 large-scale, placebo-controlled trials involving 73,238 diabetic patients. Among these patients, 3,065 were already receiving GLP-1RAs. The analysis demonstrated the significant benefits of adding SGLT2 inhibitors to existing GLP-1RA therapy.
Key Findings
- Cardiovascular Protection: SGLT2 inhibitors reduced the risk of heart attack, stroke, or cardiovascular death by 11% independently of GLP-1RAs. Furthermore, they decreased the risk of hospitalization for heart failure or cardiovascular death by 23% when combined with GLP-1RAs.
- Kidney Disease Prevention: The combination therapy also showed remarkable effects on kidney health. SGLT2 inhibitors reduced the risk of chronic kidney disease progression by 33% and slowed the annual loss of kidney function by nearly 60% when added to GLP-1RAs.
- Safety Profile: Importantly, the study reported no new safety concerns with the combined use of SGLT2 inhibitors and GLP-1 receptor agonists, indicating a safe and effective treatment strategy.
Expert Commentary
Professor Neuen emphasized the importance of the findings, stating, “The rapidly expanding indications for the use of GLP-1 receptor agonists make it crucial to understand their effects when combined with SGLT2 inhibitors. Both classes of medicines work independently of each other—SGLT2 inhibitors target heart failure and chronic kidney disease, while GLP-1 receptor agonists focus on reducing heart attack, stroke, and kidney disease.”
Conclusion
This study underscores the potential of combining SGLT2 inhibitors and GLP-1 receptor agonists to offer comprehensive protection against heart and kidney complications in diabetic patients. As the prevalence of diabetes continues to rise globally, these findings provide valuable insights for improving patient outcomes and advancing diabetes care.
