By vgreene, 10 January, 2019 If SLGT2i not tolerated or contraindicated or if eGFR less than adequate, add GLP-1 RA w/ proven CVD benefit:4
By vgreene, 10 January, 2019 If CKD: Consider use of SGLT2i or GLP1-1 RA shown to reduce CKD progression, CV events, or both [C]
By vgreene, 10 January, 2019 If high risk of HF or coexisting HF and eGFR adequate, prefer SGLT2i [C]:
By vgreene, 10 January, 2019 empagliflozin > canagliflozin (based on modestly stronger evidence, although both reduced HF and/or CKD progression in CV outcome trials)
By vgreene, 10 January, 2019 Metformin is preferred initial mono-tx; add other agents, incl insulin, to metformin; don’t delay intensified tx; reassess and modify tx every 3-6mo as needed
By vgreene, 10 January, 2019 Re-eval med regimen every 3-6mo and adjust prn to account for pt factors and regimen complexity [E]