The Impact of Diabetes Type 2 Treatment Interventions on Cardiovascular Outcomes – A Comprehensive Review
Authors:   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, Al Qarni A ,   King Abdullah International Medical Research Center (KAIMRC), Al-Ahsa, Saudi Arabia,   Endocrinology and Metabolism, Department of Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabi,   King Saud bin Abdulaziz University for Health Sciences, Al-Ahsa, Saudi Arabia, AlSubaiee M ,   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia,   King Abdullah International Medical Research Center (KAIMRC), Al-Ahsa, Saudi Arabia,   College of Nursing (CON-A), King Saud Bin Abdulaziz University for Health Sciences, Al-Ahsa, Saudi Arabia,   Endocrinology and Metabolism, Department of Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabi, Alshaikh Husain M ,   Department of Family Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, G Alkhazmari ,   Imam Abdulrahman Bin Faisal Hospital, MNGHA Dammam, Saudi Arabia, AlQahtani A ,   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, Aldossary I ,   Clinical Pharmacy Services, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia,   King Abdullah International Medical Research Center (KAIMRC), Al-Ahsa, Saudi Arabia, Gado W ,   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, Albahrani Z ,   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, AlMukhaylid S ,   College of Applied Medical Sciences (CoAMS-A), King Saud Bin Abdulaziz University for Health Sciences, Al-Ahsa, Saudi Arabia, Alarfaj A ,   Department of Family Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, Almekhloof S ,   Clinical Pharmacy Services, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia,   King Abdullah International Medical Research Center (KAIMRC), Al-Ahsa, Saudi Arabia, Alarfaj M ,   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia, AlTaweel M ,   Department of Internal Medicine, King Abdulaziz Hospital, MNGHA Al-Ahsa, Saudi Arabia,   King Abdullah International Medical Research Center (KAIMRC), Al-Ahsa, Saudi Arabia, AlMusaad A ,   King Abdullah International Medical Research Center (KAIMRC), Al-Ahsa, Saudi Arabia
Published: September 2023

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease with significant cardiovascular (CV) implications. The management of diabetes plays a crucial role in reducing the risk of cardiovascular disease (CVD) and improving patient outcomes. This review examines the impact of various therapeutic strategies and their relevance to specific demographic groups, particularly the elderly and those with chronic kidney disease (CKD). Methods: A comprehensive literature review was conducted focusing on randomized controlled trials (RCTs), meta-analyses, systematic reviews, and large observational studies from PubMed, Cochrane Library, and Google Scholar. Results: Metformin and sodium-glucose cotransporter-2 (SGLT2) inhibitors consistently reduced CV mortality by 20–38% compared to other treatments. Incretin-based therapies like liraglutide and semaglutide reduced major adverse cardiovascular events (MACE) by 13–26%. Lifestyle interventions lowered CV risk when combined with medications. SGLT2 inhibitors conferred renal and CV protection in patients with CKD. Bariatric surgery (BS) has been associated with significant improvements in CV outcomes. Conclusion: Metformin, SGLT2 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), BS, and lifestyle modification conferred CV benefits. Management of type 2 diabetes with a view to reducing CV risk requires an individualized approach, taking into account patient characteristics, comorbidities, and the CV risk profiles of various treatment options.