Diabetes Pathways

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Potential benefits of SGLT-2 inhibitors
↓ mortality	In patients with CV disease/risk: empagliflozin NNT=39 over 3.1 yrs ^EMPA-REG
↓ composite CV endpoint (MACE)*	In patients with CV disease/risk: empagliflozin NNT=63 over 3.1 yrs ^EMPA-REG canagliflozin NNT ~220 per yr ^CANVAS
↓ composite nephropathy endpoint**	In patients with nephropathy: canagliflozin NNT=23 over 2.6 yrs ^CREDENCE (Preliminary data shows this may be a class effect.)
↓ heart failure hospitalization or CV death	In patients with heart failure: dapagliflozin NNT=21 over 1.5 yrs ^DAPA-HF empagliflozin NNT=19 over 1.3 yrs ^{EMPORER-Reduced} (Preliminary data shows this may be a class effect.)
MACE = major adverse cardiovascular events; often stroke, MI, and CV death *nephropathy composite endpoint = end-stage renal disease, doubling of serum creatinine, renal/CV death

Potential benefits of GLP-1 receptor agonists
↓ mortality	In patients with CV disease/risk: liraglutide NNT=72 over 3.8 yrs ^LEADER
↓ composite CV endpoint (MACE)*	In patients with CV disease/risk: liraglutide NNT=53 over 3.8yrs ^LEADER semaglutide subcut NNT=44 over 2 yrs ^SUSTAIN-6 dulaglutide NNT=72 over 5.4 yrs ^REWIND
*MACE = major adverse cardiovascular events; often stroke, MI, and CV death