The Use of SGLT2i and GLP-1 RA in Patients with
Type 2 Diabetes in Thailand: Evidence Review and
Recommendations
Rungroj Krittayaphong MD¹, Bancha Satirapoj MD², Boonsong Ongphiphadhanakul MD³,
Kriengsak Vareesangthip MD, PhD⁴, Sompongse Suwanwalaikorn MD⁵, Wacin Buddhari MD⁶
Affiliation : ¹ Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ² Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ³ Division of Endocrinology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ⁴ Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ⁵ Division of Endocrinology, Department of Medicine. Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand ⁶ Division of Cardiovascular Medicine, Department of Medicine. Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Background: Cardiovascular (CV) and renal comorbidities are common among type 2 diabetes (T2D) patients, and significantly increase the cost
and burden of care. Both sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve key
outcomes including major CV events, hospitalization for heart failure, and renal outcomes, albeit to varying degrees in different T2D populations.
Materials and Methods: The authors reviewed evidence from GLP-1 RA and SGLT2i CV outcomes trials and real-world studies in Thailand and elsewhere.
Results: The authors formulated recommendations to guide selection of anti-diabetes medication based on patients’ clinical characteristics and CV or renal risk profile.
Conclusion: These recommendations could help guide management of CV/renal comorbidities and risk alongside glucose-lowering therapy for individual patients.
Received 16 July 2021 | Revised 3 August 2021 | Accepted 3 August 2021
doi.org/10.35755/jmedassocthai.2021.11.13163
Keywords :
Type 2 diabetes mellitus; Cardiovascular diseases; Chronic kidney disease; Clinical outcomes; SGLT2i; GLP-1 RA
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