Evidence map›Paper›PMID 33097060›Full record

ArticleCardiovascular diabetology2020

Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes.

Guntram Schernthaner, Naim Shehadeh, Alexander S Ametov, Anna V Bazarova, Fahim Ebrahimi, Peter Fasching, Andrej Janež, Péter Kempler, Ilze Konrāde, Nebojša M Lalić and 7 more

Open access · goldAbstract read
In one paragraph

Article in Cardiovascular diabetology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 1 pooled it
14.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 1 synthesis or guideline pooled it, 157 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Implementing SGLT2 Inhibitor Therapy in Line with the New NICE Guidelines for Type 2 Diabetes Management.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
    Review
  4. Article
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  8. Addressing Unmet Needs in the Management of Chronic Kidney Disease.International journal of general medicine · 2026
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30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 16 institutions in 15 countries.

Guntram SchernthanerMedical University of Vienna, Vienna, Austria. guntram@schernthaner.eu.ORCID 0000-0003-2397-4468
Naim ShehadehInstitute of Diabetes, Endocrinology and Metabolism, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Technion, P.O. Box 9602, 3109601, Haifa, Israel.
Alexander S AmetovHead of Endocrinology, Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow, Russia.
Anna V BazarovaDepartment of Internal Medicine #3, Astana Medical University (NpJSC "AMU"), 49A Beybitshilik Street, Nur-Sultan City, Kazakhstan.
Fahim EbrahimiDivision of Endocrinology, Diabetes, and Metabolism, University Hospital Basel, Basel, Switzerland.
Peter Fasching5th Medical Department With Endocrinology, Rheumatology and Acute Geriatrics, Vienna Health Association Clinic Ottakring, 37 Montleartstraße, 1160, Vienna, Austria.
Andrej JanežDepartment of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 7 Zaloška Cesta, 1000, Ljubljana, Slovenia.
Péter KemplerDepartment of Internal Medicine and Oncology, Semmelweis University, 2/a Korányi Sándor Utca, Budapest, 1083, Hungary.
Ilze KonrādeRiga Stradins University, Riga, Latvia.
Nebojša M LalićClinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Boris MankovskyDepartment of Diabetology, National Medical Academy for Postgraduate Education, Kiev, Ukraine.
Emil MartinkaNational Institute of Endocrinology and Diabetology, Lubochna, Slovak Republic.
Dario RahelićVuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia.
Cristian SerafinceanuDepartment of Diabetes, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Jan Škrha3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, 1 Ulice Nemocnice, 128 08, Prague 2, Czech Republic.
Tsvetalina TankovaDepartment of Endocrinology, Medical University - Sofia, 2 Zdrave Street, Sofia, Bulgaria.
Žydrūnė VisockienėClinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Astana Medical University · KZCarol Davila University of Medicine and Pharmacy · ROCharles University · CZInstitute of Endocrinology · CZLjubljana University Medical Centre · SIMedical University of Sofia · BGMedical University of Vienna · ATRambam Health Care Campus · ILRiga East University Hospital · LVRussian Medical Academy of Continuous Professional Education · RUSemmelweis University · HUShupyk National Healthcare University of Ukraine · UAUniversity Hospital of Basel · CHUniversity of Belgrade · RSUniversity of Zagreb · HRVilnius University · LT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The disclosure of proven cardiorenal benefits with certain antidiabetic agents was supposed to herald a new era in the management of type 2 diabetes (T2D), especially for the many patients with T2D who are at high risk for cardiovascular and renal events. However, as the evidence in favour of various sodium-glucose transporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) accumulates, prescriptions of these agents continue to stagnate, even among eligible, at-risk patients. By contrast, dipeptidyl peptidase-4 inhibitors (DPP-4i) DPP-4i remain more widely used than SGLT2i and GLP-1 RA in these patients, despite a similar cost to SGLT2i and a large body of evidence showing no clear benefit on cardiorenal outcomes. We are a group of diabetologists united by a shared concern that clinical inertia is preventing these patients from receiving life-saving treatments, as well as placing them at greater risk of hospitalisation for heart failure and progression of renal disease. We propose a manifesto for change, in order to increase uptake of SGLT2i and GLP-1 RA in appropriate patients as a matter of urgency, especially those who could be readily switched from an agent without proven cardiorenal benefit. Central to our manifesto is a shift from linear treatment algorithms based on HbA1c target setting to parallel, independent considerations of atherosclerotic cardiovascular disease, heart failure and renal risks, in accordance with newly updated guidelines. Finally, we call upon all colleagues to play their part in implementing our manifesto at a local level, ensuring that patients do not pay a heavy price for continued clinical inertia in T2D.

Indexed as

Blood GlucoseCardiovascular DiseasesDiabetes Mellitus, Type 2Glycemic ControlIncretinsKidney DiseasesSodium-Glucose Transporter 2 InhibitorsBiomarkersClinical Decision-MakingEvidence-Based MedicineGlobal HealthGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsHumansPractice Guidelines as TopicPractice Patterns, Physicians'BiomarkersBlood GlucoseGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsIncretinsSodium-Glucose Transporter 2 InhibitorsCardiorenal protectionClinical inertiaGlucose lowering drugsType 2 diabetes

Identifiers

PMID33097060
PMCPMC7585305
OpenAlexW3093773039

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.