• Leigh Morrison, Jonathan Gabison, and Lauren Oshman.
• From the Clinical Assistant Professor, Department of Family Medicine, University of Michigan (LM, JG); Associate Professor, Department of Family Medicine, University of Michigan (LO). morrisol@med.umich.edu.
• J Am Board Fam Med. 2024 May 1; 37 (3): 372382372-382.

AbstractThe landscape of diabetes management has changed, such that the goal of pharmacotherapy extends beyond glucose-lowering to prioritize risk reduction of cardiovascular disease and diabetic kidney disease. Two newer classes of medications, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2-Is), have become first line therapies for many patients with type 2 diabetes to reduce cardiovascular and renal complications of type 2 diabetes. This review article will describe the mechanism of action, evidence for cardiovascular and kidney outcomes, contraindications, adverse effects, and risk mitigation strategies for the GLP-1 RA and SGLT2-I drug classes. In addition, we will provide a practical approach for primary care clinicians to prescribe, adjust, and combine these medication classes, while considering patient preference, tolerability, comorbidities, cost, and availability.© Copyright 2024 by the American Board of Family Medicine.

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