{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T20:56:47Z","timestamp":1784753807401,"version":"3.55.0"},"reference-count":40,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fundo de Incentivo \u00e0 Pesquisa do Hospital de Cl\u00ednicas de Porto Alegre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>New antihyperglycemic medications have been proven to have cardiovascular (CV) and renal benefits in type 2 diabetes mellitus (T2DM); however, an evidence-based decision tree in specific clinical scenarios is lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Systematic review and meta-analysis of randomized controlled trials (RCTs), with trial sequential analysis (TSA). Randomized controlled trial inclusion criteria were patients with T2DM from 1 of these subgroups: elderly, obese, previous atherosclerotic CV disease (ASCVD), previous coronary heart disease (CHD), previous heart failure (HF), or previous chronic kidney disease (CKD). Randomized controlled trials describing those subgroups with at least 48 weeks of follow-up were included. Outcomes: 3-point major adverse cardiovascular events (MACE), CV death, hospitalization due to HF, and renal outcomes. We performed direct meta-analysis with the number of events in the intervention and control groups in each subset, and the relative risk of the events was calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) were the only antihyperglycemic agents related to a reduction in CV events in different populations. For obese and elderly populations, GLP-1 RA were associated with benefits in 3-point MACE; for patients with ASCVD, both SGLT2i and GLP-1 RA had benefits in 3-point MACE, while for patients with CHD, only SGLT2i were beneficial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SGLT2i and GLP-1 RA reduced CV events in selected populations: SGLT2i led to a reduction in events in patients with previous CHD, ASCVD, and HF. GLP-1 RA led to a reduction in CV events in patients with ASCVD, elderly patients, and patients with obesity. Trial sequential analysis shows that these findings are conclusive. This review opens a pathway towards evidence-based, personalized treatment of T2DM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>PROSPERO CRD42019132807<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa534","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T19:06:42Z","timestamp":1597432002000},"page":"3588-3599","source":"Crossref","is-referenced-by-count":12,"title":["Patient-centered Management of Type 2 Diabetes Mellitus Based on Specific Clinical Scenarios: Systematic Review, Meta-analysis and Trial Sequential Analysis"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0954-8622","authenticated-orcid":false,"given":"Lana C","family":"Pinto","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade 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Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana V","family":"Viana","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia T","family":"Pulz","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana P","family":"Carpena","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical 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Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mileni V","family":"Beretta","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elis F","family":"Pedrollo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiz\u00e1 M","family":"Londero","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Machry","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lais","family":"Janeczko","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Endocrine Division, Hospital de Cl\u00ednicas de Porto Alegre, Endocrine Division, Ramiro Barcelos, Porto Alegre, 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