Evaluating the Effects of Canagliflozin on Cardiovascular and Renal Events in Patients with Type 2 Diabetes and Chronic Kidney Disease According to Baseline HbA1c, Including Those with HbA1c <7%: Results From the CREDENCE Trial.

Cannon, Christopher P; Perkovic, Vlado; Agarwal, Rajiv; Baldassarre, James; Bakris, George; Charytan, David M; de Zeeuw, Dick; Edwards, Robert; Greene, Tom; Heerspink, Hiddo J L; Jardine, Meg J; Levin, Adeera; Li, Jing-Wei; Neal, Bruce; Pollock, Carol; Wheeler, David C; Zhang, Hong; Zinman, Bernard; Mahaffey, Kenneth W

Traditional management of diabetes mellitus has focused on glycemic control, beginning with lifestyle changes, followed by metformin, and then other classes of antiglycemic agents.1 Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce cardiovascular (CV) events, including CV death, myocardial infarction (MI) and heart failure, and slow progression of renal dysfunction, including prevention of end-stage kidney disease (ESKD).2-3 Because initial clinical trials included mostly patients with baseline HbA1c >7%, current guidelines have recommended this class as add-on therapy for patients whose HbA1c is not at goal, typically ≥7%.1 We hypothesized that there would be similar benefits on CV and renal endpoints regardless of baseline HbA1c, including those with HbA1c <7%.