HEART FAILURE: Edited by Haissam HaddadTreatment of diabetes and heart failure a paradigm shift for cardiologists?Brochu, Bradleya; Chan, MichaelbAuthor Information aMazankowski Alberta Heart Institute and University of Alberta bCK Hui Heart Centre, Royal Alexandra Hospital and University of Alberta, Edmonton, Alberta, Canada Correspondence to Michael Chan, MBBS, FRCPC, FACC, CK Hui Heart Centre (Robbins Pavilion), Royal Alexandra Hospital, 6th Floor, Room 6S132B-8, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada. E-mail: [email protected] Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-cardiology.com). Current Opinion in Cardiology: March 2019 - Volume 34 - Issue 2 - p 207-212 doi: 10.1097/HCO.0000000000000599 Buy SDC Metrics Abstract Purpose of review Diabetes is a well-recognized risk factor for the development of cardiovascular disease. In recent years, several new glucose-lowering drugs (GLD) have shown improvements in cardiovascular outcomes, renewing interest of cardiovascular specialists in diabetes management. Recent findings Individual studies in the last 5 years have demonstrated the cardiovascular safety of certain dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 agonists, and sodium glucose cotransporter 2 inhibitors. Recent meta-analyses have attempted to demonstrate class effects of these medications, but remain driven by several large studies. Other studies have used registry data to show improvements in cardiovascular outcomes in patients receiving new GLD compared with insulin therapy. The cardiovascular benefits of GLD are so attractive that these agents have been applied to patients without diabetes, though these studies have not borne a net clinical benefit in nondiabetic patients. Summary An evolving body of literature now supports the safety profile of many new GLDs in patients at risk for cardiovascular disease. Several new agents have demonstrated improvements in cardiovascular outcomes and are now recommended as second-line agents after metformin in patients with cardiovascular disease. http://links.lww.com/HCO/A54 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.