Among the newest glucose-lowering agents for the treatment of type 2 diabetes, two classes raise much interest: glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter type 2 (SGLT2) inhibitors. Indeed, both showed a cardiovascular protection in dedicated outcome studies in patients with type 2 diabetes at high cardiovascular risk. ^,  These findings had a major effect on the newer guidelines for the management of type 2 diabetes. In patients with atherosclerotic cardiovascular disease, guidelines now recommend, after failure of metformin monotherapy, the addition of a GLP-1 receptor agonist or an SGLT2 inhibitor that was shown to reduce the risk of major cardiovascular events. In the absence of heart failure or renal disease, two conditions in which SGLT2 inhibitors appear more protective, the clinician can choose between these two pharmacological options without specific guidance in the absence of comparative trials.

中文翻译：

---

SGLT2抑制剂或GLP-1受体激动剂在2型糖尿病中的作用？

在用于治疗2型糖尿病的最新降糖药中，有两类引起了人们的极大兴趣：胰高血糖素样肽1（GLP-1）受体激动剂和钠葡萄糖共转运蛋白2型（SGLT2）抑制剂。确实，在专门的结局研究中，两者均显示出对心血管风险高的2型糖尿病患者的心血管保护作用。^， 这些发现对新的2型糖尿病治疗指南产生了重大影响。现在，在患有动脉粥样硬化性心血管疾病的患者中，指南建议在二甲双胍单药治疗失败后，添加GLP-1受体激动剂或SGLT2抑制剂，可降低重大心血管事件的风险。在没有心力衰竭或肾脏疾病（SGLT2抑制剂表现出两种保护作用的两种情况）的情况下，在没有比较试验的情况下，临床医生可以在这两种药理学选择之间进行选择而无需特别指导。