Treatment for Type 2 Diabetes Reduces Major CV Events in Men

Two classes of medications—SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1RA) —are used to treat type 2 diabetes (T2D) and reduce major adverse cardiovascular events in patients with T2D. According to a recent population-based cohort study, SGLTi can reduce the risk of major cardiovascular events in men when compared to its use in women.

The researchers of the study looked at men and women aged 30 and older who were living with T2D. The patients were hospitalized between July 2013 and July 2017, and were prescribed SGLT2i or GLP-1RA within 60 days of being discharged.

The study included 8026 patients, 44.3% of whom were women. In a median follow-up period of 756 days, the researchers saw greater reductions in cardiovascular events in men when compared with women. More men were likely to be given SGLT2i after hospital discharge (60% men vs 24% women), and SGLT2i had a better rate of cardiovascular reduction in men when compared with GLP-1RAs.

“With a maximum follow-up period of 5 years, we identified that SGLT2i, in a head-to-head comparison with GLP-1RAs, reduced the rates of major adverse cardiovascular events in Australian men, men and women ≥65 years, men with a history of heart failure, and women with baseline atherosclerotic [cardiovascular disease] CVD,” the authors wrote.

The study does have limitations. For example, the authors noted that their findings may not reflect the effects of SGLT2i and GLP-1RAs on non-hospitalized patients with T2D. Further, although they adjusted for several confounders, the authors also noted that residual confounding could still be a possibility considering that the Victorian Admitted Episodes Dataset did not offer data on duration or severity of patients’ diabetes, nor other risk factors like obesity and smoking status.

Still, the authors believe their study offers an important view on personalized treatment of patients with T2D and CVD.

“These findings may provide initial insights to develop more personalised treatment approaches for male and female people with T2D and CVD,” the researchers concluded.

Reference:

Sharma A, Wood S, Bell JS, De Blasio MJ, Ilomäki J, Ritchie RH. Sex differences in risk of cardiovascular events and mortality with sodium glucose co-transproter-2 inhibitors versus glucagon-like peptide 1 receptor agonists in Australians with type 2 diabetes: a population-based cohort study. Lancet Reg Health West Pac. Published online January 30, 2023. doi:10.1016/j.lanwpc.2023.100692