Glucagon-Like Peptide-1 and Dual Incretin Agonists in Type 2 Diabetes with Peripheral Artery Disease: A Systematic Review and Meta-Analysis of Vascular, Cardiovascular, Metabolic, and Mortality Outcomes : Incretin Therapy in T2DM and PAD.

PURPOSE OF REVIEW: Peripheral artery disease (PAD) is a serious complication in type 2 diabetes, increasing vascular morbidity and mortality. While glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists show cardiovascular benefits in diabetes, their effects on PAD-related outcomes are unclear. This meta-analysis assessed the impact of these therapies on vascular outcomes in type 2 diabetes with PAD. RECENT FINDINGS: A systematic review and meta-analysis were conducted per PRISMA guidelines (PROSPERO CRD420251083622). PubMed, Embase, and Cochrane Central were searched. A random-effects model pooled data. Primary outcomes were major adverse limb events, peripheral revascularization, and amputation. Secondary outcomes included major adverse cardiovascular events (MACE), all-cause mortality, myocardial infarction, stroke, HbA1c, and weight changes. Six studies (four RCTs, two propensity score-matched cohorts) with 25,866 patients were included. Incretin-based therapies significantly reduced all-cause mortality (RR 0.52 [0.28–0.95], p = 0.032) and HbA1c (MD − 0.73% [–1.32 to − 0.15], p = 0.013) compared to placebo or standard care. No significant differences were found for major adverse limb events, revascularization, amputation, MACE, myocardial infarction, or stroke. Heterogeneity and low evidence certainty were noted.

Duke Scholars

Author N. Alejandro (Alex) Barbagelata Medicine, Cardiology