New diabetes drugs for heart patients

There are two newer classes of type 2 diabetes medications that can reduce the risk of heart disease. These drugs not only lower blood sugar, but have the additional effect of improving heart outcomes in certain patients.  

One class of drugs are sodium-glucose co-transporter-2 (SGLT2) inhibitors.  These medications lower blood sugar by helping the body excrete it in urine. Examples include canagliflozin, dapagliflozin and empagliflozin.  They also help prevent excess fluid from building up in the body, which reduces the risk of developing heart failure.

The other class of medication that received FDA approval are glucagon-like peptide 1 receptor agonists (GLP-1 RA). They help the  pancreas release the proper amount of insulin to keep blood sugar levels in check. They also make patients feel full longer, can lead to weight loss and reduce the risk of heart disease and stroke.  Liraglutide, semaglutide and dulaglutide are examples. These drugs should not be prescribed in patients with a family or personal history of medullary thyroid cancer or multiple endocrine neoplasia type 2 syndrome.  

Before starting any new drug, you should discuss the drug with your doctor and review potential side effects. Adjustments in your current diabetes drugs, particularly insulin and sulfonylureas may be needed.