Effect of Medications for Type 2 Diabetes on Cardiovascular Events and Mortality: A Comprehensive Pairwise and Network Meta-Analysis.
Diabetes Obes MetabJul 30, 2026 (epub)
Giovanni Antonio Silverii, Valerio Velardi, Christian Marinelli et al.
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In 30 seconds
This network meta-analysis evaluated the impact of various type 2 diabetes medications on major adverse cardiovascular events (MACE) and all-cause mortality across 93 randomized controlled trials. Results indicated that GLP-1 receptor agonists, SGLT-2 inhibitors, and tirzepatide significantly reduced MACE and all-cause mortality, with metformin also showing a reduction in MACE (OR 0.69, 95% CI 0.53-0.89).
Key findings
- GLP-1 receptor agonists, SGLT-2 inhibitors, and tirzepatide significantly reduced MACE compared to placebo.
- Tirzepatide, SGLT-2 inhibitors, and GLP-1 receptor agonists were associated with significantly reduced all-cause mortality.
- Metformin was associated with a reduction in MACE (OR 0.69, 95% CI 0.53-0.89) versus placebo.
- Sulfonylureas were linked to an increased incidence of MACE.
Why it matters
Understanding the cardiovascular effects of diabetes medications is crucial for optimizing treatment strategies in patients with type 2 diabetes, particularly given the increased cardiovascular risk in this population.