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( Figure 5 ) Briefly, SGLT2i inhibits the SGLT receptors in the proximal tubule, which inhibits the reabsorption of glucose from primary urine, resulting in glycosuria and a decrease in HbA1c and fasting glucose levels ( Figure 5 Clinical implications Given the significant cardioprotective effect of SGLT2i and GLP-1RAs, the ADA guidelines state that all diabetic patients with confirmed or subclinical cardiovascular disease should be prescribed a GLP-1RA class or SGLT2i class with proven cardiovascular benefit, regardless of the patients HbA1c level or the presence of other glucose-lowering medications ( Strengths and limitations To the best of our knowledge, this is the first meta-analysis to assess the effects of SGLT2i and GLP-1RAs as first-line therapeutic agents in T2DM patients with low cardiovascular disease risk

This multi receptor approach is intended to increase satiety, reduce appetite, improve blood sugar control, and stimulate energy expenditure

Discuss alcohol use with your prescribing provider before drinking, especially if you're on insulin or other blood sugar medications alongside your GLP-1 therapy

Neurology 1989;39:291-302