In 2016, the U.S. Food and Drug Administration revised the metformin label to reflect its safety in people with an estimated glomerular filtration rate of 30 mL per minute per 1.73 m2 or greater. When the estimated glomerular filtration rate is between 30 and 45 mL per minute per 1.73 m2, a maximum daily dosage of 1,000 mg and close monitoring of renal function are recommended.

A large randomized clinical trial showed that empagli flozin (Jardiance), a sodium-glucose cotransporter-2 inhibitor, reduced a composite outcome of myocardial infarction, stroke, and cardiovascular death in people with established arteriosclerotic cardiovascular disease compared with placebo.

A 2023 systematic review found that glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors reduce cardiovascular-related deaths, nonfatal myocardial infarction, hospital admissions, end-stage renal disease, and all-cause mortality.