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ESC 2023 Diabetes

2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes

The 2023 ESC diabetes guideline makes SGLT2 inhibitors and GLP-1 receptor agonists with proven cardiovascular benefit a foundation of care independent of glucose control, and introduces a dedicated SCORE2-Diabetes risk model. The register's landmark cardiovascular-outcome trials are grouped by drug class below.

This guideline cites 6 of the 199 landmark trials in our Cardiology register.

Source
Marx N, Federici M, et al. Eur Heart J. 2023;44(39):4043–4140. · European Heart Journal
Read the full guideline ↗

SGLT2 inhibitors — CV outcomes2

  • 2019DECLARE-TIMI 58Cardiology · Cardiometabolic · SGLT2 inhibitorsDapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes
  • 2015EMPA-REG OUTCOMECardiology · Cardiometabolic · SGLT2 inhibitorsEmpagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes

GLP-1 receptor agonists2

  • 2016LEADERCardiology · Cardiometabolic · GLP-1 RALiraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results
  • 2016SUSTAIN-6Endocrinology · GLP-1 RA · CV outcome trialTrial to Evaluate CV and Other Long-term Outcomes with Semaglutide

Renal protection in diabetes2

  • 2020DAPA-CKDNephrology · CKD · SGLT2 inhibitorsDapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease
  • 2019CREDENCENephrology · CKD · SGLT2 inhibitorsCanagliflozin and Renal Events in Diabetes with Established Nephropathy

Published since the guideline5

  • 2025SURPASS-CVOTCardiology · Cardiometabolic · GIP/GLP-1 RAA Study of Tirzepatide Compared with Dulaglutide on Major Cardiovascular Events in Participants with Type 2 Diabetes
  • 2025SOULCardiology · Cardiometabolic · oral GLP-1 RAA Heart Disease Study of Semaglutide in Patients with Type 2 Diabetes (Semaglutide cardiOvascular oUtcomes triaL)
  • 2025SURMOUNT-5Cardiology · Cardiometabolic · GIP/GLP-1 RAA Study of Tirzepatide Compared With Semaglutide in Participants With Obesity or Overweight
  • 2025SUMMITCardiology · Cardiometabolic · Obesity & HFpEFTirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity
  • 2024FLOWNephrology · CKD · GLP-1 RASemaglutide and Kidney Outcomes in Type 2 Diabetes with Chronic Kidney Disease