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This study assessed the cardiorenal efficacy and safety of various glucose-lowering therapies (GLTs). It included 43 trials comparing nine types of GLTs and found that glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sodium-glucose cotransporter-2 inhibitors (SGLT-2is), and thiazolidinediones reduced major cardiovascular events compared to other GLTs. GLP-1 RAs were favorable for cardiovascular and renal outcomes, while SGLT-2is showed a significant reduction in renal outcomes. Thiazolidinedione therapy increased heart failure hospitalizations and had no mortality benefit. Adverse events leading to drug discontinuation were higher with GLP-1 RAs and thiazolidinediones.
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