A network meta-analysis finds both SGLT2 inhibitors and GLP-1 agonists reduce cardiovascular and renal risk in type 2 diabetes, with differences in specific outcomes.
Both classes reduce MACEIndirect comparison suggests potential differential benefits for heart failure vs. atherosclerotic events
What the researchers found
Both SGLT2 inhibitors and GLP-1 RAs significantly reduce cardiovascular and renal events in type 2 diabetes, with potential differential benefits for specific outcomes.
Why it matters
Clinicians need guidance on choosing between SGLT2 inhibitors and GLP-1 RAs (or using both) for patients with type 2 diabetes at cardiovascular/renal risk.
How the study worked
Systematic review and network meta-analysis of large-scale placebo-controlled cardiovascular outcome trials using frequentist methods.
What this study cannot tell us
Network meta-analysis relies on indirect comparisons — inherently less reliable than direct head-to-head trials; heterogeneity across trials may affect results.
How to read the evidence
Network meta-analysis of RCTs — strong methodology but limited by indirect comparisons in the absence of head-to-head trials.
When this study was published
Published 2026 in Cureus. Synthesizes the latest cardiovascular outcome trial data.
The bigger picture
As both SGLT2i and GLP-1 RAs become foundational therapies for cardiometabolic protection, understanding their relative strengths helps optimize treatment sequencing and combination strategies.
Questions still open
- Should combination SGLT2i + GLP-1 RA be standard for high-risk diabetes patients?
- Do specific agents within each class differ in cardiorenal protection?
Common questions
Which is better for the heart — SGLT2 inhibitors or GLP-1 drugs?
Should patients take both types of medication?
Read the original research
Comparative Effectiveness of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors Versus Glucagon-Like Peptide-1 (GLP-1) Agonists on Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.
Cureus, 18(1), e100927
Citation
Alqurain, Aymen A; Salem, Manal; Algarzai, Bashayer A; Eljadi, Eman M; Elsayed, Hazem S; Almuhanna, Ahmed; Albuhayji, Deema S; Salami, Mohammad; Alzahrani, Joud; Alsayyali, Juri; Alqarni, Abdulrahman; Alqahtani, Nessreen; Alotaibi, Fay T; Alyami, Gharam G. (2026). Comparative Effectiveness of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors Versus Glucagon-Like Peptide-1 (GLP-1) Agonists on Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.. Cureus, 18(1), e100927. https://doi.org/10.7759/cureus.100927