The Canadian Diabetes Association (CDA) has provided an interim update to their clinical practice guidelines for the pharmacologic management of type 2 diabetes. The guidelines initially published in 2013, are set to be fully updated in 2018, and contain a provision allowing individual chapters to be updated in the event of significant changes in supporting evidence.
This update follows the results of a recent cardiovascular outcome studies (EMPAREG OUTCOME) for the sodium glucose transporter 2 (SGLT2) inhibitor, empagliflozin. This is the first trial to demonstrate cardiovascular superiority with antihyperglycemic treatment. In this trial significantly fewer patients receiving empagliflozin died from cardiovascular causes or experienced a nonfatal myocardial infarction or nonfatal stroke when compared to placebo.
These findings are significant to the diabetic population as 40% to 60% of individuals with diabetes will die from cardiovascular disease. As a result, the CDA now prioritizes the presence of clinical cardiovascular disease when adding an antihyperglycemic and recommends an SGLT2 inhibitor with demonstrated CV benefits in this patient population.