Introduction: Early initiated and long-term sustained intensive glucose control is associated with a significantly decreased risk of cardiovascular events and all-cause mortality, over and above the well-established decline in the risk of microvascular disease. Based on the recent cardiovascular outcome trial (CVOT) data, this review focuses on the various benefits of the newer medications with their positioning in the treatment algorithm and explores the place of the older medications in the management of type 2 diabetes mellitus (T2DM).Areas covered: We searched the literature for glucose-lowering therapies for patients with T2DM. We included CVOTs conducted for newer sulphonylureas, thiazolidinediones, insulin degludec, DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists.Expert opinion: Selection of glucose-lowering therapy in the management of T2DM should be individualized and based on patient characteristics, associated comorbidities, patient preference, affordability and adherence to treatment. In view of the benefits seen in the CVOTs with SGLT2 inhibitors and GLP-1 receptor agonists, these newer classes should be the preferred choice in patients with/without established atherosclerotic cardiovascular disease and chronic kidney disease.

中文翻译：

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降糖疗法的心血管结果试验。

简介：早期开始和长期持续的强化血糖控制与心血管事件和全因死亡率的风险显着降低相关，超过了公认的微血管疾病风险下降。根据最近的心血管结局试验 (CVOT) 数据，本综述重点关注新药的各种益处及其在治疗算法中的定位，并探讨旧药在 2 型糖尿病 (T2DM) 管理中的地位。涵盖的领域：我们检索了 T2DM 患者降糖疗法的文献。我们纳入了针对新型磺脲类药物、噻唑烷二酮类药物、德谷胰岛素、DPP-4 抑制剂、SGLT2 抑制剂和 GLP-1 受体激动剂进行的 CVOT。专家意见：2 型糖尿病管理中降糖治疗的选择应个体化，并基于患者特征、相关合并症、患者偏好、负担能力和治疗依从性。鉴于 SGLT2 抑制剂和 GLP-1 受体激动剂在 CVOT 中的益处，这些较新的类别应该是有/没有确定的动脉粥样硬化性心血管疾病和慢性肾病患者的首选。