Precision Prescribing of SGLT2 Inhibitors in Type 2 Diabetes for Primary Prevention of Heart Failure

Precision Prescribing of SGLT2 Inhibitors for Heart Failure Prevention in Type 2 Diabetes

For people living with type 2 diabetes, preventing future heart failure is an important clinical goal. Sodium-glucose cotransporter 2 inhibitors, or SGLT2 inhibitors, are a class of glucose-lowering medications that have transformed diabetes care because they not only lower blood sugar, but also reduce the risk of heart failure and slow kidney disease progression. They are now widely recommended for patients with type 2 diabetes who already have atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease.

However, most people with type 2 diabetes do not have those conditions at the time treatment decisions are made. For this much larger group, current guidelines do not clearly identify who is most likely to gain the greatest heart failure prevention benefit from starting an SGLT2 inhibitor. This study aimed to solve that problem by developing and validating a prediction model that estimates an individual patient’s absolute heart failure benefit from SGLT2 inhibitor therapy.