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).

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

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

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

Reduced kidney, heart failure, cerebrovascular, and glycemic risk