Glucose lowering drug or strategy dependent impact of weight reduction on the prevention of CVD outcomes in Type 2 diabetes: a systematic review of CV outcome trials (CVOTs)
Authors' conclusion
In CVOTs, treatment of T2D patients resulted in BWL, which correlated with reduction in risk for CV outcomes, particularly with GLP-1 RAs. However, interventional non-CVOTs are warning that in the absence of structured behavioral intervention and relevant medication, the large BWL might be harmful for CV outcomes.
Study context
- Population
- Adult T2D patients in CVOTs, observational cohort studies or post hoc analyses of clinical trials19 RCTs + 6 strategy studies
- Participants
- 379.904 patients
- Comparison
- Higher vs lower body weight loss (BWL) during glucose-lowering drugs (GLP-1 RA, DPP-4i, SGLT2i) or strategies (intensive treatment or standard care)
- Outcome
- Association of BWL with cardiovascular (CV) outcomes and/or all-cause mortality
Methodological detailsDatabases: PubMed, Cochrane, Scopus, 19 RCTs of novel glucose-lowering drugs and 6 RCT or observational trials of different strategies
- Databases: PubMed, Cochrane, Scopus
- 19 RCTs of novel glucose-lowering drugs and 6 RCT or observational trials of different strategies
Pooled result
As reported in the abstract
MACE risk by magnitude of BWL
- GLP-1 RA: higher BWL vs lower BWL associated with greater decrease in MACE risk
- DPP-4i: no such effect
- SGLT2i: greater decrease in MACE risk associated with lower BWL
- Other strategies: higher BWL led to increased risk of MACE and all-cause mortality
Original publication
Glucose lowering drug or strategy dependent impact of weight reduction on the prevention of CVD outcomes in Type 2 diabetes: a systematic review of CVOTs. Diabetes Res Clin Pract. Published 13 August 2024. doi:10.
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