1/6
#ADA2021
Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)

Q. What next after metformin?

MET plus:
✅GLP-1ra (liraglutide)
✅Insulin(glargine)
✅SU (glimepiride)
✅DPP4i (sitagliptin)

But
😱 No SGLT2i
😱 No TZD

care.diabetesjournals.org/content/36/8/2… 2/6
Mean baseline characteristics

57 yr old
♀️36%
66%👴🏻, 20%👴🏿
BMI 34
HbA1c 7.5%
Duration of diabetes 4.2 yr

⚠️🇺🇸 only study
⚠️only 3.6% from 'Asian' descent
⚠️ So not representative to non-🇺🇸 #type2diabetes

care.diabetesjournals.org/content/42/11/…

AMPLITUDE-O Trial
1/5
Cardiovascular outcome trial for Efpeglenatide an investigational once weekly Exendin-4 based GLP-1ra.

What are the unanswered questions
Do Exendin-based GLP-1a ⤵️ MACE❓
Do GLP-1ra ⤵️ MACE in people taking SGLT2i❓
Does GLP-1ra ⤵️ renal decline❓

#ADA2021 2/5
Main results

Efpeglenatide
⤵️3-point MACE by 27%
⤵️expanded MACE by 21%
⤵️Renal composite by 32%
⤵️MACE or non-CV death by 27%

Best data yet to suggest adding GLP-1ra to SGLT2i ⤵️MACE

@DLBHATTMD

#ADA2021
1/6
✅Real world data from a 🇩🇪register of patients with ♂️#hypogonadism & #type2diabetes over 12 years!

❗️ ♂️ hypogonadism is common in T2D (≈ 50%)

⚠️@Bayer presented
⚠️ other data shown ⤴️ MACE
amjmed.com/article/S0002-…

So what did they find? 2/6

Baseline Characteristics.

🤔As you can see two very different cohorts of patients.

⚠️ High risk of unresolved bias