{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T02:22:33Z","timestamp":1782354153362,"version":"3.54.5"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"Supplement_B","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Fondazione Umbra Cuore e Ipertensione-ONLUS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Metformin is a frequently used anti-diabetic drug. In addition to the well-known modulating properties on glyco-metabolic control, metformin reduces cardiovascular (CV) risk partly independently of its anti-hyperglycaemic effect. The use of \u2018new\u2019 anti-diabetic drugs, inhibitors of the renal Na-glucose co-transporter (SGLTs-I or \u2018gliflozines\u2019) and GLP-1 receptor agonists (GLP1-RAs), has further contributed to challenge the strictly \u2018gluco-centric\u2019 view of diabetic CV disease. Several controlled trials have demonstrated that the cardio-renal benefits of gliflozines and GLP1-RAs are present regardless of the presence of metformin as \u2018background\u2019 therapy. The impact on the \u2018cardio-renal continuum\u2019 exerted by SGLTs-I was also noted in non-diabetic patients with heart failure and reduced or preserved ventricular function and different levels of renal function. These drugs reduced re-hospitalization, CV mortality, and progression to end-stage renal disease. These clinical acquisitions, implemented by Scientific Societies, have led to a change in the therapeutic approach to diabetic cardio-renal disease. Although metformin still represents a valid therapeutic option to be offered particularly to \u2018na\u00efve\u2019 diabetic patients without previous cardio-renal events, SGLTs-I and\/or GLP1-RAs emerge as \u2018first-line\u2019 drugs in diabetic patients with previous CV events, or at high CV risk, without having to request \u2018on board\u2019 metformin therapy.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suad098","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T17:58:59Z","timestamp":1682099939000},"page":"B171-B176","source":"Crossref","is-referenced-by-count":10,"title":["Therapy of Type 2 diabetes: more gliflozines and less metformin?"],"prefix":"10.1093","volume":"25","author":[{"given":"Paolo","family":"Verdecchia","sequence":"first","affiliation":[{"name":"Umbra Heart and Hypertension Foundation-ONLUS and Department of Cardiology, S. 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