The Medical Letter on Drugs and Therapeutics
Cardiovascular Effects of Some Antidiabetic Drugs
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Revised 8/25/17: See GLP-1 Receptor Agonists, end of first paragraph.

For many years, the goal of drug therapy for most patients with type 2 diabetes has been to achieve and maintain an A1C of <7%. Achieving that goal can prevent microvascular complications (diabetic retinopathy, nephropathy, neuropathy), but whether it prevents macrovascular complications (myocardial infarction [MI], stroke) has been less clear. The FDA now requires that cardiovascular safety studies be performed for all new drugs for type 2 diabetes.1 Recent findings that some of the newer second-line drugs for type 2 diabetes have cardiovascular benefits have led to new interest in the cardiovascular efficacy and safety of all antidiabetic drugs.2,3

METFORMIN — The oral biguanide metformin (Glucophage, and others) is the drug of choice for initial treatment of type 2 diabetes, but its cardiovascular effects have not been ... more      

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