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Is time ready for combination therapy at diagnosis of type 2 diabetes?
Author(s) -
Prattichizzo Francesco,
Ceriello Antonio
Publication year - 2021
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3460
Subject(s) - metformin , type 2 diabetes , medicine , intensive care medicine , combination therapy , diabetes mellitus , pharmacology , endocrinology
Emerging evidence is showing a range of beneficial effects for GLP‐1 receptor agonists and especially SGLT‐2 inhibitors on the cardio‐renal axis in patients with type 2 diabetes (T2D) and cardiovascular diseases (CVD). Preliminary findings suggest that: 1‐ such benefit extends also to patients with T2D without pre‐existing CVD; and 2‐ background therapies do not modify the effect of these drugs. Given these considerations, some authors advanced the hypothesis that these novel agents might undermine the first‐line position of metformin in the treatment algorithm of T2D. Here, we briefly discuss some pros and cons of such scenario, proposing a “starting” combination therapy with metformin plus one novel agent with trial‐proven benefit as the best option to make use of the available knowledge and minimize the risk of complications in patients with newly diagnosed T2D.