While good glycemic control has been shown to prevent microvascular complications (e.g. retinopathy, nephropathy, neuropathy), only a few anti-diabetic agents have been shown to reduce macrovascular complications (e.g. cardiovascular events. Empagliflozin, a sodium glucose transporter-2 (SGLT2) inhibitor, not only reduced the risk of CV events but also all-cause mortality in the EMPA-REG OUTCOME study.  Based on this data, the SGLT2 inhibitors were given favorable second-line treatment status in the most recent AACE/ACE clinical practice guidelines. But do all SGLT2 inhibitors confer the same benefits… and risks? The Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes (CANVAS) trial assessed the cardiovascular and renal benefits from long-term canagliflozin use.  The results are both reassuring and unexpected.

Guest Author:  Sean Lasota, Pharm.D.

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