[SGLT2 inhibitor or GLP-1 receptor agonist in a patient with type 2 diabetes and cardiovascular disease ?].

Two classes of antidiabetic agents have shown a cardiovascular and renal protection in patients with type 2 diabetes and high cardiovascular risk. Empagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, and liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, were granted a reduction of major cardiovascular events and mortality after the positive results of EMPA-REG OUTCOME and LEADER outcome trials, respectively. Protection mechanisms most probably differ between the two pharmacological classes and are perhaps complementary. The question that may arise in clinical practice is to know which drug should be selected between these two options in a patient with type 2 and established cardiovascular disease, before considering a potential combination. The aim of this article is to discuss about the best therapeutic choice according to the patient individual profile and the specificities of each molecule.