Antihyperglycemic therapies including sodium glucose contransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have been demonstrated to confer significant cardiovascular benefit and reduce future events in patients with type 2 diabetes mellitus (T2DM). However, despite positive data from cardiovascular outcome trials, these therapies remain underutilized in a large proportion of patients who have clinical indications and meet coverage guidelines for their initiation. One of the causes of the observed gap between scientific evidence and clinical cardiology practice is therapeutic hesitancy (otherwise known as therapeutic inertia). The purpose of this review is to discuss the contributors to therapeutic hesitancy in the implementation of these evidence-based therapies and, more importantly, provide pragmatic solutions to address these barriers.

中文翻译：

---

开药许可：心脏病专家开出对心血管有益的糖尿病药物是否需要获得许可？

包括钠葡萄糖转运蛋白 2 抑制剂 (SGLT2i) 和胰高血糖素样肽 1 受体激动剂 (GLP-1 RA) 在内的抗高血糖疗法已被证明可为 2 型糖尿病 (T2DM) 患者带来显着的心血管益处并减少未来事件。然而，尽管来自心血管结局试验的积极数据，这些疗法在大部分具有临床适应症并符合开始治疗的覆盖指南的患者中仍未得到充分利用。观察到的科学证据与临床心脏病学实践之间存在差距的原因之一是治疗犹豫（也称为治疗惰性）。本综述的目的是讨论在实施这些循证疗法时出现治疗犹豫的原因，更重要的是，