Glycaemic control and macrovascular and microvascular outcomes in type 2 diabetes: Systematic review and meta‐analysis of cardiovascular outcome trials of novel glucose‐lowering agents
Authors' conclusion
SGLT-2is and GLP-1RAs showed consistent risk reductions in macrovascular and microvascular outcomes. The vascular benefits of SGLT-2is and GLP-1RAs in patients with T2D extend beyond mere glycaemic control.
Study context
- Population
- Patients with T2D in placebo-controlled cardiovascular outcome trials (CVOTs) of newer glucose-lowering agents (MEDLINE, Embase, Cochrane Library until September 2023)
- Participants
- 169,513 patients20 CVOTs
- Comparison
- SGLT2i, GLP-1 RA and DPP-4i vs placebo
- Outcome
- Macrovascular and microvascular outcomes; relationship between HbA1c reduction and risk of these outcomes
Methodological detailsplacebo-controlled cardiovascular outcome trials, meta-regression
- Placebo-controlled cardiovascular outcome trials
- Meta-regression
Pooled result
As reported in the abstract
3-point MACE
Each group vs placeboHazard ratio (95% CI)
SGLT-2is
0.88(0.82–0.94)
GLP-1RAs
0.85(0.79–0.92)
DPP-4is
1.00(0.94–1.06)
Further pooled results
Meta-regression: 3-point MACE risk per 1% HbA1c reduction
- Estimated risk per 1% reduction in HbA1c
- 0.84 (95% CI 0.67-1.06; p = .14; R2 = 14.2%)
- Driven by non-fatal stroke component (p = .094)
- R2 = 100.0%
- Potential evidence of an inverse linear relationship
HbA1c reduction and other vascular outcomes
- Non-significant inverse linear relationships between HbA1c reduction and risk of several vascular outcomes
Original publication
Glycaemic control and macrovascular and microvascular outcomes in type 2 diabetes: Systematic review and meta‐analysis of cardiovascular outcome trials of novel glucose‐lowering agents. Diabetes Obes Metab. Published 20 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →