Effect of non-insulin-based glucose-lowering therapies on cardiovascular outcomes in patients with type 2 diabetes.

Current guidelines for the treatment of patients with diabetes are focused on improving glycemic control and treating appropriate cardiovascular (CV) risk factors. Basic recommendations include blood pressure management with a goal of <140 mm Hg systolic pressure, statin therapy in all patients ≥40 years of age with diabetes (moderate intensity for all, and high intensity if at high risk of CVD events), and aspirin therapy in all adults at increased CV risk (10-year risk of CVD events >10%). Oral antihyperglycemic medications remain the cornerstone of treatment for optimizing glucose control in patients with diabetes. In this review, we aim to present the basic mechanisms for each class of commonly used non-insulin-based glucose-lowering drugs and to discuss the effect of these medications on CV events.