For people living with type 2 diabetes, the risk of serious health problems like heart attacks, strokes, and kidney failure is a major concern. Doctors have traditionally used two powerful classes of drugs to help: GLP-1 receptor agonists and SGLT2 inhibitors. While both drugs are known to be effective on their own, a common question has emerged: what happens if we use them both at the same time?
The Power of Large Trials
To find the answer, medical science uses the results of large randomized controlled trials (RCTs). These studies involve tens of thousands of people. By comparing people taking the medicine to those taking a placebo (a pill with no medicine), researchers can determine if a drug actually prevents death, heart attacks, or kidney failure.
Understanding the Two Drug Classes
Data from these trials shows that both drugs are highly effective:
- GLP-1 Receptor Agonists: These reduce the risk of major heart events (like heart attacks and strokes) by about 14% and kidney failure by 15%.
- SGLT2 Inhibitors: These are especially strong at protecting the heart from heart failure (32% reduction) and slowing down kidney disease progression (37% reduction).
Does Combining Them Work?
The “good news” is that these two drugs appear to work independently. This means that one drug does not interfere with the other; instead, they both keep doing their specific jobs. When used together, their benefits actually add up.
For example, because they work in different ways, combining them can lead to a 23% reduction in major heart events and a large 58% reduction in the risk of kidney function decline.
The Bottom Line
Doctors don’t necessarily need to know every tiny detail of how these drugs work to know that they do work. The evidence from large trials collectively including over 100,000 people with type 2 diabetes shows that combining these treatments is a safe and effective way to provide “double protection” for the heart and kidneys. When used together, people with type 2 diabetes have a much better chance of staying healthy in the long run.
About the author
Hertzel Gerstein
Hertzel is an endocrinologist and professor at McMaster University who is in high demand as a speaker, advocate, and educator on diabetes-related topics. His research focuses on using large, international randomized trials to identify and test new ways of preventing type 2 diabetes, reducing serious health outcomes like strokes and death, and achieving type 2 diabetes remissions.
