Glucose-Lowering Drugs to Reduce Cardiovascular Risk in Type 2 Diabetes

To the Editor: In her Clinical Practice article, Kalyani (April 1 issue) 1 gives limited attention to kidney outcomes with glucose-lowering agents, except for mention of the CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) and DAPA-CKD (Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease) trials, which were focused on patients with established chronic kidney disease (CKD). The signal is now clear that sodium–glucose cotransporter type 2 (SGLT2) inhibitors can limit the development or progression of CKD, with four cardiovascular outcome trials in type 2 diabetes showing a strong and highly consistent relative kidney benefit . . .