The choice between an SGLT2i or GLP1RA - SGLT2i is typically preferable if renal disease or heart failure predominates (GLP1RA is preferable if CVA predominates). If the HbA1c remains above target in this high-risk group, dual SGLT2i (and GLP1RA therapy is recommended but not funded in NZ).

Formal Recommendations

Recommendation & Evidence

Recommendation Strength-
Evidence Level-
Recommendation direction

Categories

Cardiovascular Disease and Risk Management
Recommendation No.: 2-2024-035E-030R Guideline No.: 2-2024-035EGuideline: Samoa MOH National Diabetes Guidelines

PICO Question

P

Population

People with type 2 diabetes at high cardiorenal risk requiring treatment escalation

I

Intervention

Prefer an SGLT2 inhibitor when kidney disease or heart failure predominates; prefer a GLP-1 receptor agonist when cerebrovascular disease predominates; use both if HbA1c remains above target

C

Comparison

SGLT2 inhibitor versus GLP-1 receptor agonist according to the predominant comorbidity

O

Outcome

Not reported

Evidence Information

Evidence No.-
Evidence-
Evidence Level-
Recommendation Strength-
Statement TypeFormal Recommendations

Guideline Information

Guideline NameSamoa MOH National Diabetes Guidelines
Guideline No.2-2024-035E
AuthorAlec Ekeroma
Guideline TypeGuideline
Year2024
OrganizationMinistry of Health Samoa
RegionOceania
CountrySamoa
Conflict of InterestNo
DOI无
Target Population所有糖尿病患者（包括1型糖尿病、2型糖尿病、妊娠期糖尿病、儿童及青少年），特别是萨摩亚及太平洋人群，包括高危人群（超重/肥胖、有家族史、既往糖尿病史等）
Journal无
Recommendation Strength MethodologyNone
Evidence Level MethodologyNone

Other Information

Living GuidelineNo
Rapid AdviceNo
UpdatedNo
Recommendation Count0
Reference Count50
Guideline TopicComprehensive
CategoriesCardiovascular Disease and Risk Management
Created At2026-10-21 14:39:47
Updated At2026-10-21 14:39:47