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Abstract
<p class="first" id="P1">Type 2 diabetes mellitus (T2DM) is a major cardiovascular
(CV) risk factor. Although
antihyperglycemic therapies have typically focused on glycemic control, a paradigm
shift for the treatment of T2DM has occurred, with an increased focus on CV risk reduction.
Clinicians should base their clinical decisions on the beneficial effects of specific
glucose-lowering agents on CV outcomes, while avoiding those therapeutic strategies
with potential detrimental effects. Importantly, the presence of comorbidities (eg,
established cardiovascular diseases, hypertension, obesity) should also guide the
clinical decision toward therapies proven to reduce CV outcomes in that specific population.
In this state-of-the-art review resulting from a comprehensive literature search (Pubmed,
Google Scholar), we summarize the evidence related to the CV outcomes trials reported
in the past several decades. Finally, we propose a therapeutic plan for patients with
T2DM, suggesting the use of specific glucose-lowering agents based on the characteristics
and presence of comorbidities of the individual patient.
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