By vgreene, 8 March, 2019 TZD (low dose may be better tolerated, but less well studied for CVD effects)
By vgreene, 8 March, 2019 If further tx intensification needed A1C still above target or pt now unable to tolerate GLP 1 RA or SGLT2 I consider tx intensification based on co morbidities pt centered tx factors mgmt needs choose agents demonstrating CV safety neutrality
By vgreene, 8 March, 2019 If established ASCVD or indicators of high ASCVD risk 1 incorporate either a GLP 1 RA w proven CVD benefit or a SGLT2 I w proven CVD benefit if eGFR adequate A
By vgreene, 8 March, 2019 SGLT2-I w/ proven CVD benefits:1 empagliflozin > canagliflozin (based on modestly stronger evidence)
By vgreene, 8 March, 2019 GLP1-RA w/ proven CVD benefits:1 liraglutide > semaglutide > exenatide ER (based on strongest evidence)
By vgreene, 8 March, 2019 If pt 65 yo Consider coexisting conditions cognition functional status w care to avoid symptomatic hyperglycemia and minimize risk of acute hyperglycemia complications B 4