Diabetes is one of the most common health problems worldwide, accounting for more than 1.5 billion deaths per year. This study aims to evaluate the effector sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in patients with type-2 diabetes at varying risk of cardiovascular and renal disease.

This network meta-analysis included randomized controlled trials comparing the efficacy and safety of SGLT-2 inhibitors or GLP-1 receptor agonists with standard care, placebo, The primary outcomes of the study were the risk of cardiovascular disease and chronic kidney disease based on a guided panel.

The analysis included 764 trials involving 421,346 patients. The findings suggested that both classes of drugs lowered all-cause mortality, non-fatal myocardial infarction, cardiovascular mortality, and kidney failure. However, notable differences were found between the two agents, as SGLT-2 inhibitors reduced mortality and hospital admission more than GLP-1 receptor agonists, and GLP-1 receptor agonists reduced fatal stroke more than SGLT-2 inhibitors. In terms of adverse events, SGLT-2 inhibitors caused a genital infection, whereas GLP-1 receptor agonists caused severe gastrointestinal events.

The research concluded that in patients with type-2 diabetes, both SGLT-2 inhibitors and GLP-1 receptor agonists reduced the risk of cardiovascular disease, renal disease, and death.

Ref: https://www.bmj.com/content/372/bmj.m4573