Cited by 192Diabetes Treatment and ManagementChronic Kidney Disease and DiabetesHeart Failure Treatment and Management

Combination therapy with GLP ‐1 receptor agonist and SGLT2 inhibitor

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DeFronzo, Ralph A.·2017·Diabetes, Obesity and Metabolism

Abstract

The SGLT2 inhibitors ( SGLTi ) and glucagon‐like‐1 receptor agonists ( GLP ‐1 RAs ) effectively reduce HbA1c , but via very different mechanisms, making them an effective duet for combination therapy. Recently, drugs in both of these antidiabetic classes have been shown to reduce cardiovascular events, most probably by different mechanisms. SGLT2i appear to exert their CV protective actions by haemodynamic effects, while GLP ‐1 RAs work via anti‐atherogenic/anti‐inflammatory mechanisms, raising the possibility that combined therapy with these 2 classes may produce additive CV benefits. The SGLT2i and GLP ‐1 RAs also reduced macroalbuminuria, decreased the time for doubling of serum creatinine, and slowed the time to end‐stage renal disease. In this perspective, we review the potential benefit of combination SGLT2i / GLP ‐1 RA therapy on metabolic‐cardiovascular‐renal disease in patients with type 2 diabetes mellitus.

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  1. [6]DeFronzo RA Ferrannini E Regulation of intermediary metabolism Endocrinology James JL DeGroot LJ Sanders/Elsevier 6th 2014 673 698 Philadelphia, PA
  2. [7]Abdul-Ghani M Mujahid O Mujahid A DeFronzo RA Zirie M Jayyousi A Efficacy of exenatide in combination with pioglitazone versus basal/bolus insulin in T2DM patients with very high glycated hemoglobin: results from the QATAR study JCEM (in press)

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Authors
DeFronzo, R. A.
Affiliations
The University of Texas at San Antonio Health Science Center (US)
Corresponding author
DeFronzo, Ralph A.
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2017-06-07
Volume
19
Issue
10
Pages
1353-1362
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
OpenAlex
W2607109151
Cited by
192
References
79
Citations by year
2026: 20 · 2025: 21 · 2024: 28 · 2023: 17 · 2022: 19 · 2021: 25 · 2020: 20 · 2019: 17 · 2018: 20 · 2017: 5
FWCI
2.47
Type
journal article
Language
en
Open access
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (DK24092‐33)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords
SGLT2 inhibitors, GLP-1 receptor agonists, combination therapy, type 2 diabetes, cardioprotection, renal protection, albuminuria, end-stage renal disease, anti-inflammatory mechanism, hemodynamic effects, glycemic control
MeSH terms
Sodium-Glucose Transporter 2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Drug Therapy, Combination, Humans, Hypoglycemic Agents, Kidney Failure, Chronic, Disease Progression, Sodium-Glucose Transporter 2

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