Fig. 2

Evidence-based algorithm for the management of patients with T2DM and established ASCVD. ASCVD atherosclerotic cardiovascular disease, GLP-1 glucagon-like peptide-1, SGLT2 sodium–glucose transporter proteins-2, TZD thiazolidinedione, DPP4 dipeptidylpeptidase-4. ^aProven CVD benefits means the agent has a label indication of reducing the CVD events. For GLP-1 agonist evidence based preference is Liraglutide > Semaglutide > Exenatide > Lixenatide. Caution to be exercised in case of end-stage renal disease. ^bFor SGLT2 inhibitors evidence based preference is Empagliflozin > Canagliflozin. ^cLow dose TZDs are better tolerated. To be cautiously added to the patients with no history of heart failure and active surveillance to be maintained throughout the treatment. ^dChoose later generation SU to minimize the risk of hypoglycaemia. ^eDegludec and insulin Glargine (U100) have shown CVD safety