Updated 2019 Guidelines for Managing High Blood Sugar in Type 2 Diabetes from the American and European Diabetes Associations

GLP-1 receptor agonists and SGLT2 inhibitors may reduce major adverse cardiovascular events in high-risk individuals.

• Treatment with a GLP-1 receptor agonist or SGLT2 inhibitor is recommended for high-risk individuals to reduce major adverse cardiovascular events, hospitalization for heart failure, cardiovascular death, or chronic kidney disease progression.
• GLP-1 receptor agonists may be beneficial for patients with type 2 diabetes who do not have established cardiovascular disease but present with specific high-risk indicators.
• SGLT2 inhibitors are suggested for patients with type 2 diabetes and heart failure, particularly those with reduced ejection fraction, to decrease hospitalization for heart failure, major adverse cardiovascular events, and cardiovascular death.
• SGLT2 inhibitors are also recommended for patients with type 2 diabetes and chronic kidney disease with an estimated glomerular filtration rate between 30 to ≤60 mL/min or a urinary albumin-to-creatinine ratio greater than 30 mg/g.

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