Patients with Type 2 Diabetes (T2D) are at risk of developing macrovascular (cardiac, cerebrovascular, peripheral arterial disease) and microvascular (nephropathy, neuropathy, retinopathy) complications. Glycemic control improves only microvascular outcomes. However, some SGLT-2 inhibitors and GLP1-R agonists have proven beneficial in macrovascular conditions. Canagliflozin is an SGLT2 inhibitor that provides sustained reductions in HbA1c, blood pressure and weight. Remarkably, as CANVAS program and CREDENCE trial demonstrated, canagliflozin promotes significant reductions in the frequency of atherosclerotic cardiovascular events, hospitalizations for heart failure and renal outcomes. In addition, real-world studies have confirmed the results of clinical trials in clinical practice. Therefore, canagliflozin should be considered a first-line therapy in the management of T2D patients in order to reduce both micro- and macrovascular complications.
Keywords: CANVAS; CREDENCE; HbA1c; canagliflozin; cardiovascular; diabetes; heart failure; renal.
Lay abstract Type 2 Diabetes (T2D) is a condition that increases the risk of developing different complications, including cardiovascular conditions or chronic kidney disease, among others. Although reducing blood sugar levels to recommended targets is important, this only has a partial impact on these outcomes. However, newer antidiabetic drugs, such as some SGLT-2 inhibitors have proven to be beneficial in the prevention and recovery from major cardiac events, heart failure and renal disease. Canagliflozin, an SGLT2 inhibitor: provides sustained reductions in blood sugar levels, blood pressure and weight. Remarkably, important clinical trials have demonstrated that canagliflozin promotes significant reductions in the frequency of cardiovascular events, hospitalizations for heart failure and renal outcomes. Therefore, canagliflozin should be considered in the management of T2D patients.