Fig. 3

Evidence-based algorithm for the management of patients with T2DM and HF or HF + ASCVD. ASCVD atherosclerotic cardiovascular disease, HF heart failure, GLP-1 glucagon-like peptide-1, SGLT2 sodium–glucose transporter proteins-2, DPP4 dipeptidylpeptidase-4. ^aboth empagliflozin and canagliflozin have shown reduction in HF in CVOT trials. ^bFor GLP-1 agonist evidence based preference is Liraglutide > Semaglutide > Exenatide > Lixenatide. Caution to be exercised in case of end-stage renal disease. ^cProven CVD benefits means the agent has a label indication of reducing the CVD events. ^dChoose later generation SU to minimize the risk of hypoglycaemia. ^eDegludec and insulin Glargine (U100) have shown CVD safety. Avoid thiazolidinediones, saxagliptin or Alogliptin in patients with ASCVD and HF