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LEADER randomized more than 9,000 patients with type 2 diabetes and high cardiovascular risk to liraglutide or placebo. Liraglutide significantly reduced the primary composite of cardiovascular death, nonfatal myocardial infarction or nonfatal stroke and also reduced all-cause mortality. These findings were among the key studies that moved GLP-1 receptor agonists into the cardiovascular-risk conversation. For internal-medicine practice, the significance is that therapy selection can be driven by organ protection as well as glucose lowering. Patients with established cardiovascular disease or multiple risk factors may therefore warrant consideration of agents with proven cardiovascular benefit. Clinicians still need to address weight, blood pressure, lipids, smoking and kidney disease, because a single medicine does not replace comprehensive risk-factor management. The trial also provides a useful framework for explaining why modern diabetes care has shifted from a glucose-centric model to a broader cardiometabolic model.
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LEADER randomized more than 9,000 patients with type 2 diabetes and high cardiovascular risk to liraglutide or placebo. Liraglutide significantly reduced the primary composite of cardiovascular death, nonfatal myocardial infarction or nonfatal stroke and also reduced all-cause mortality. These findings were among the key studies that moved GLP-1 receptor agonists into the cardiovascular-risk conversation. For internal-medicine practice, the significance is that therapy selection can be driven by organ protection as well as glucose lowering. Patients with established cardiovascular disease or multiple risk factors may therefore warrant consideration of agents with proven cardiovascular benefit. Clinicians still need to address weight, blood pressure, lipids, smoking and kidney disease, because a single medicine does not replace comprehensive risk-factor management. The trial also provides a useful framework for explaining why modern diabetes care has shifted from a glucose-centric model to a broader cardiometabolic model.
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