Diabetes and CVD module 3: Drugs for diabetes – the cardiovascular evidence base

Released20 September 2018     Expires: 20 September 2020      Programme: Diabetes and CVD 0.5 CPD/CME credit, 0.5 hours

Sponsorship Statement: AstraZeneca provided an unsolicited arms-length educational grant to fund the production of this supplement. AstraZeneca had no editorial input into the content other than a review for technical accuracy.

Designed to give healthcare professionals an understanding of the effectiveness of the range of drugs for diabetes, in the management of cardiovascular disease in the patient with diabetes.

Learning objectives

After completing this module, participants should be better able to understand:

  • Cardiovascular (CV) randomised-controlled trials (RCTs) with newer hypoglycaemic agents have helped to guide therapies in diabetes. Agents in the dipeptidyl-peptidase family are CV neutral with some glucagon-like peptide (GLP) analogues showing vascular protection. Agents in the sodium-glucose co-transporter (SGLT) family have shown CV protection with the added benefit of reducing heart failure risk and potential favourable renal effects
  • Data from one RCT should not be generalised to other members of the class, and each agent requires separate assessment
  • The widespread belief that metformin is CV protective is, in our opinion, not based on robust evidence, although current knowledge suggests this agent is at worst CV neutral. In contrast, agents in the sulfonylurea group have been associated with increased CV risk, although conclusive large-scale CV outcome trials are currently lacking
  • There is inconsistency in the quality of CV risk assessment comparing older and newer hypoglycaemic agents, which should be taken into account when drawing up guidelines and making treatment recommendations. Some recent guidelines have taken newer trial data into account when making recommendations for those with diabetes and CV disease


Sam M Pearson, Specialist Registrar in Diabetes and Endocrinology, St James’s University Hospital, Leeds
Ramzi A Ajjan, Associate Professor and Consultant in Diabetes and Endocrinology, The LIGHT Laboratories, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds

With thanks to Dr Sam Pearson for assistance on the self-assessment aspect of the programme.


0.5 CPD/CME credit, 0.5 hours
BJC Learning has assigned half an hour of CPD/CME credit to this module

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It shall not, by way of trade or otherwise, be lent, re-sold, hired or otherwise circulated without the publisher’s prior consent.

Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs becomes necessary. The editors/authors/contributors and the publishers have taken care to ensure that the information given in this text is accurate and up to date. Readers are strongly advised to confirm that the information, especially with regard to drug usage, complies with the latest legislation and standards of practice.

Healthcare professionals should consult up-to-date Prescribing Information and the full Summary of Product Characteristics available from the manufacturers before prescribing any product. Medinews (Cardiology) Limited cannot accept responsibility for any errors in prescribing which may occur.