COMPARATIVE EVALUATION OF THE SINGLE AND COMBINED EFFECTS OF GLP-1 RECEPTOR AGONISTS AND SGLT2 INHIBITORS

Аннотация

Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance, impaired β-cell function, excess body weight, and the development of cardiovascular and renal complications. In recent years, pharmacotherapeutic approaches aimed not only at improving glycemic control but also at reducing cardiorenal and metabolic risks have been increasingly developed. GLP-1 receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors play an important role in this therapeutic approach. This article provides a comparative analysis of the effects of GLP-1 receptor agonists and SGLT2 inhibitors used as monotherapies and in combination on glycemic control, body weight, arterial blood pressure, lipid metabolism, and renal function. GLP-1 receptor agonists primarily improve glycemic control by enhancing glucose-dependent insulin secretion, suppressing glucagon secretion, and slowing gastric emptying, while also contributing to body weight reduction. SGLT2 inhibitors, in contrast, reduce renal glucose reabsorption and exert their effects through insulin-independent glycosuria, while providing important cardiorenal protective benefits. Because these two pharmacological classes have distinct and complementary mechanisms of action, their combination represents a promising therapeutic approach for achieving comprehensive metabolic control.