Diabetes: how to manage cardiovascular risk in secondary prevention patients

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Atherosclerotic cardiovascular disease (ASCVD) commonly affects people with type 2 diabetes (T2D). Historically, traditional cardiovascular (CV) risk-lowering therapies in patients with T2D and ASCVD have included antiplatelet agents, blood pressure-lowering therapies, lipid-lowering therapies and healthy lifestyle modifications. In the past decade, multiple antihyperglycaemic agents have emerged as CV risk-lowering therapies in this population as well. This article provides a narrative review on the current non-glycaemic and glycaemic treatment options for CV risk reduction in patients with T2D and ASCVD. The FDA requirement that all new antihyperglycaemic agents undergo cardiovascular outcomes trials has demonstrated increasing evidence to support the role of glucagon-like peptide 1 (GLP1) receptor agonists and sodium–glucose cotransporter 2 (SGLT2) inhibitors as first-line agents for both glycaemic control and CV risk reduction in this population.

Keywords: atherosclerotic cardiovascular disease, cardiovascular disease, diabetes, GLP1 receptor agonists, SGLT2 inhibitors, type 2 diabetes.

Citation: Anderson SL, Marrs JC. Diabetes: how to manage cardiovascular risk in secondary prevention patients. Drugs Context. 2022;11:2021-10-1. https://doi.org/10.7573/dic.2021-10-1

Contributions: All authors contributed equally to the preparation of this manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/01/dic.2021-10-1-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2022 Anderson SL, Marrs JC. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2022 Anderson SL, Marrs JC. https://doi.org/10.7573/dic.2021-10-1. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/diabetes-how-to-manage-cardiovascular-risk-in-secondary-prevention-patients

Correspondence: Sarah Anderson, 12001 Sunrise Valley Dr, Suite 300, Reston, VA 20191. Email: sanderson@clinicaloptions.com

Provenance: Invited; externally peer reviewed.

Submitted: 1 October 2021; Accepted: 16 December 2021; Publication date: 14 June 2022.

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