| Summary: | The overall impact of glucose-lowering on vascular complications and major clinical outcomes, including mortality, in type 2 diabetes is still an open issue. While intensive glucose control has undoubted benefit for microvascular endpoints, the relationship between glucose-lowering approaches and reduced incidence and/or progression of macrovascular complications is less clear. This presentation will discuss the effect of glucose-lowering per se as well as the effects of specific glucose-lowering therapies on vascular outcomes in type 2 diabetes. Recent analyses from large cardiovascular outcome studies (ACCORD, ADVANCE, VADT) provide new information on factors that modulate the impact of intensive glucose-lowering on outcomes, helping to identify the specific clinical characteristics of the patients receiving the intervention that would show better response. Several studies on cardiovascular outcomes with diabetes drugs are now available, and they highlight cardiovascular benefits from using specific medications, as for the SGLT-2 blockers and some GLP-1 receptor agonists.
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