GLP-1 RECEPTOR AGONISTS AND SGLT-2 INHIBITORS BEYOND GLYCEMIC CONTROL: CARDIOVASCULAR BENEFITS IN THE TREATMENT OF TYPE 2 DIABETES MELLITUS

Abstract

This article aimed to critically analyze the current literature regarding the mechanisms of action of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose co-transporter 2 inhibitors (SGLT2is), in addition to their glycemic control effects in the treatment of type 2 diabetes mellitus (T2DM), reviewing their cardiovascular benefits. Both medications have become established as pillars in the glycemic management of patients with T2DM, also addressing the complications associated with this heterogeneous disease. Their mechanisms of action were described, analyzing their efficacy, therapeutic synergy, and impact on the most prevalent disease-related complications. The search was conducted in the PubMed and DOAJ databases, encompassing systematic reviews and meta-analyses published between 2018 and 2025, as well as the current guidelines from the Brazilian Diabetes Society. The results show consistent benefits in blood pressure control, reduction of atherosclerotic progression, mitigation of heart failure (HF) worsening, and major adverse cardiovascular events (MACE), along with renal protection, in addition to glycemic control. These findings reinforce the need to consider these medications not only as glucose-lowering agents but also as integrated therapies for cardiovascular and renal protection in the management of T2DM and its complications. Despite these promising effects, the heterogeneity of studies and variability in patient response highlight the need for individualized evaluation of outcomes.