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This is a corrected version of the article that appeared in print.

Am Fam Physician. 2022;105(6):675-677

 This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• To reduce overall mortality in patients with type 2 diabetes mellitus, the BMJ/MAGIC Group recommends prescribing SGLT-2 inhibitors in those with cardiovascular disease and/or chronic kidney disease or three or more risk factors for cardiovascular disease.

• GLP-1 receptor agonists are reasonable alternatives to SGLT-2 inhibitors in patients with similar risk profiles because this drug class also improves mortality, although to a lesser extent.

• Although SGLT-2 inhibitors and GLP-1 receptor agonists do not increase the risk of severe hypoglycemia, SGLT-2 inhibitors increase the risk of genital infections, and GLP-1 agonists have gastrointestinal adverse effects, especially at initiation and with high doses.

From the AFP Editors

Management of patients with type 2 diabetes mellitus is evolving. Instead of focusing on how treatment affects markers of glycemic control, which has not shown benefit, treatments should be based on anticipated reductions in cardiovascular and kidney disease outcomes. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists demonstrate consistent risk reductions for mortality, myocardial infarction, stroke, heart failure, and renal outcomes, irrespective of their effects on glycemia. The BMJ/MAGIC Group performed a systematic review to determine which patients may benefit from SGLT-2 inhibitors or GLP-1 receptor agonists.
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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

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