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Background <p>Diabetes still relevantly impairs the quality of life and life expectancy, with atherosclerotic events being the main cause of premature mortality. Sodium-glucose transporter&#xa0;2 inhibitors (SGLT2i) and glucagon-like peptide&#xa0;1 receptor agonists (GLP1RA) have introduced a&#xa0;new era of diabetes treatment focusing on organ protection.</p> Objective <p>To describe the strategy, goals, benefits and side effects of using newer antidiabetic drugs.</p> Material and methods <p>Narrative review article on current recommendations and the literature.</p> Results <p>The use of GLP1RA and SGLT2i is recommended for organ protection in people with diabetes and atherosclerotic disease, heart failure and kidney disease. While they are comparably effective in reducing the risk of cardiovascular events, SGLT2i are recommended for prevention of heart failure-related hospitalization and preferentially over GLP1RA for renal protection. Incretin agonists should be used to protect against metabolic-associated steatotic dysfunction and with an underlying atherosclerotic disease. The GLP1RA and SGLT2i differ in their glucose-lowering and weight-reducing efficacy, with certain incretin agonists having an advantage over SGLT2i. Side effects, such as gastrointestinal intolerance with GLP1RAs as well as urogenital infections and the rare but potentially fatal (euglycemic) diabetic ketoacidosis under treatment with SGLT2i should be considered especially in the context of interventions such as vascular surgery.</p> Discussion <p>High-risk individuals in particular benefit from GLP1RA and/or SGLT2i combination treatment due to the complementary effects. The developments in diabetes pharmacotherapy promise new substances and further organ protection in the future.</p>

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Eine neue Ära der Diabetestherapie – Komorbiditäten im Fokus!

  • 期刊论文

  • 发表日期：

    2025年4月28日

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  • Young Hee Lee-Barkey,
  • Abdulwahab Arbi,
  • Spasija Parizova,
  • Ernest Danch,
  • Florian Willecke,
  • Bernd Stratmann,
  • Susanne Tan

摘要

Background

Diabetes still relevantly impairs the quality of life and life expectancy, with atherosclerotic events being the main cause of premature mortality. Sodium-glucose transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP1RA) have introduced a new era of diabetes treatment focusing on organ protection.

Objective

To describe the strategy, goals, benefits and side effects of using newer antidiabetic drugs.

Material and methods

Narrative review article on current recommendations and the literature.

Results

The use of GLP1RA and SGLT2i is recommended for organ protection in people with diabetes and atherosclerotic disease, heart failure and kidney disease. While they are comparably effective in reducing the risk of cardiovascular events, SGLT2i are recommended for prevention of heart failure-related hospitalization and preferentially over GLP1RA for renal protection. Incretin agonists should be used to protect against metabolic-associated steatotic dysfunction and with an underlying atherosclerotic disease. The GLP1RA and SGLT2i differ in their glucose-lowering and weight-reducing efficacy, with certain incretin agonists having an advantage over SGLT2i. Side effects, such as gastrointestinal intolerance with GLP1RAs as well as urogenital infections and the rare but potentially fatal (euglycemic) diabetic ketoacidosis under treatment with SGLT2i should be considered especially in the context of interventions such as vascular surgery.

Discussion

High-risk individuals in particular benefit from GLP1RA and/or SGLT2i combination treatment due to the complementary effects. The developments in diabetes pharmacotherapy promise new substances and further organ protection in the future.