For type 2 diabetes with established cardiovascular disease, which therapeutic class reduces major adverse cardiovascular events?

For type 2 diabetes with established cardiovascular disease, which therapeutic class reduces major adverse cardiovascular events?

• A. Metformin
• B. DPP-4 inhibitors
• C. SGLT2 inhibitors
• D. Insulin

Answer: (C)

SGLT2 inhibitors have the strongest evidence for lowering major adverse cardiovascular events in people with type 2 diabetes and established cardiovascular disease. By promoting glycosuria and causing modest diuresis and blood pressure reduction, they lessen cardiac workload and protect kidney function, which together translate into fewer cardiovascular events and fewer hospitalizations for heart failure in major cardiovascular outcome trials. While metformin is a cornerstone for glucose control and may offer some cardiovascular benefit, its impact on reducing MACE in this specific high-risk population is not as robust. DPP-4 inhibitors tend to have neutral cardiovascular effects, and insulin improves glycemic control but does not reliably reduce MACE and can increase hypoglycemia risk and weight gain. So, the class with the clearest evidence for reducing major adverse cardiovascular events in this scenario is SGLT2 inhibitors.

SGLT2 inhibitors have the strongest evidence for lowering major adverse cardiovascular events in people with type 2 diabetes and established cardiovascular disease. By promoting glycosuria and causing modest diuresis and blood pressure reduction, they lessen cardiac workload and protect kidney function, which together translate into fewer cardiovascular events and fewer hospitalizations for heart failure in major cardiovascular outcome trials. While metformin is a cornerstone for glucose control and may offer some cardiovascular benefit, its impact on reducing MACE in this specific high-risk population is not as robust. DPP-4 inhibitors tend to have neutral cardiovascular effects, and insulin improves glycemic control but does not reliably reduce MACE and can increase hypoglycemia risk and weight gain. So, the class with the clearest evidence for reducing major adverse cardiovascular events in this scenario is SGLT2 inhibitors.