People with type 2 diabetes already face a higher risk of serious health problems, including heart disease, stroke, kidney disease, and early death.
The situation becomes even more challenging when they also have atrial fibrillation, often called Afib.
Afib is the most common type of irregular heartbeat. Instead of beating in a steady rhythm, the upper chambers of the heart beat irregularly, making it easier for blood clots to form. If a clot travels to the brain, it can cause a stroke. The condition also increases the risk of heart failure and other complications.
Because both type 2 diabetes and atrial fibrillation are becoming more common around the world, doctors are looking for the best treatments for people living with both conditions. A new study from the University at Buffalo has provided important evidence that may help guide those decisions.
The research, published in Diabetes Research and Clinical Practice, compared two popular groups of diabetes medicines. One group is called glucagon-like peptide-1 receptor agonists, or GLP-1 receptor agonists.
These medicines include semaglutide, sold under brand names such as Ozempic and Wegovy, and liraglutide. They help lower blood sugar, reduce appetite, and often lead to weight loss.
The second group is called sodium-glucose cotransporter-2 inhibitors, or SGLT-2 inhibitors. This group includes medicines such as empagliflozin, sold as Jardiance, and dapagliflozin, sold as Farxiga. These medicines lower blood sugar by helping the kidneys remove extra glucose through urine. They are also well known for protecting the heart and kidneys in many patients.
Until now, doctors have had little evidence to help them decide which group of medicines is better for people who have both type 2 diabetes and atrial fibrillation.
The study was led by Dr. Md Mohaimenul Islam and Dr. Arinze Nkemdirim Okere from the University at Buffalo School of Pharmacy and Pharmaceutical Sciences. The researchers analysed medical records from 108 health systems across the United States, making it the largest direct comparison of these two medicine classes in this group of patients.
The team compared 18,035 people who started taking a GLP-1 medicine with another 18,035 people who started an SGLT-2 inhibitor. The researchers then followed their health outcomes for one year.
The results showed that patients taking GLP-1 medicines generally had better outcomes. They were 36 percent less likely to die from any cause during the study period. They were also 12 percent less likely to be admitted to hospital.
Their risk of major cardiovascular events, including heart attack, stroke, or death from heart disease, was 22 percent lower. In addition, they were 20 percent less likely to need a medical procedure to treat atrial fibrillation.
The benefits were seen across different age groups and body weights, suggesting the results were consistent for many types of patients.
Even so, the researchers stressed that these findings do not mean everyone should switch to GLP-1 medicines. SGLT-2 inhibitors remain one of the best treatments for people who already have heart failure or advanced chronic kidney disease.
Large clinical trials have shown that these medicines provide strong long-term protection for those conditions, and current medical guidelines continue to recommend them.
The researchers also pointed out that this study has important limitations. It was an observational study based on electronic health records rather than a randomized clinical trial.
This means the researchers observed what happened in real-life medical practice but could not control every factor that might influence the results. Other differences between patients may partly explain some of the findings.
The study only followed patients for one year, so it could not measure the longer-term effects of either treatment. The research team plans to carry out additional studies to better understand which patients benefit most from each medicine.
This study provides valuable real-world evidence for doctors treating patients who have both atrial fibrillation and type 2 diabetes. Its very large sample size makes the findings more reliable than many earlier studies. However, because it was observational, it cannot prove that GLP-1 medicines directly caused the better outcomes.
Randomized clinical trials are still needed. The results suggest that GLP-1 medicines may be the better choice for many patients with both conditions who do not already have heart failure or advanced kidney disease, while SGLT-2 inhibitors remain essential for patients with established heart or kidney problems.
The findings support a personalized approach in which doctors choose treatment based on each patient’s overall health rather than relying on a single medicine for everyone.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.
For more health information, please see recent studies about how drinking milk affects risks of heart disease and cancer, and results showing strawberries could help prevent Alzheimer’s disease.
Source: University at Buffalo.
