Changes in the regulatory guidelines by the Food and Drug Administration and the European Medical Agency requiring large-scale trials that study the cardiovascular safety of new glucose-lowering drugs have improved understanding of type 2 diabetes mellitus. Unexpectedly, these trials demonstrated that sodium glucose cotransporter 2 inhibitors (SGLT2i) reduce adverse cardiovascular outcomes. This second part of this two-part review summarizes the findings of recent clinical trials and their clinical implications, as well as describes ongoing trials and future areas of research.

Editors

Editor-in-Chief
Valentin Fuster, MD, PhD, MACC

CME Editor
Ragavendra R. Baliga, MD

Authors
Thomas A. Zelniker, MD, MSC

Eugene Braunwald, MD

CME Information

Target Audience

JACC Journal CME/MOC/ECME is intended for physicians who treat patients with cardiovascular disease.

Important Dates

Date of Release: January 27, 2020
Term of Approval/Date of CME/MOC/ECME Expiration: January 26, 2021

Learner Objectives

After reading this article the reader should be able to:

• Discuss the unexpected results of EMPA-REG OUTCOMES (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients).
• Discuss the evidence that sodium-glucose cotransporter 2 inhibitors (SGLT2i) may be effective in the treatment of patients with heart failure without diabetes mellitus.
• Discuss the mechanism responsible for the genital infections observed in patients with diabetes mellitus treated with an SGLT2i.

Method of Participation and Claiming Credit
This ACC JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions.  

Requesting AMA PRA Category 1 CME Credit™ and/or MOC, or ECME credit for this Activity
To request credit, you must:

1. Read the article for which you wish to receive credit.
2. Answer the self-assessment questions. You need to have achieved a passing score of 70% or better in order for the Evaluation link to become activated. If you did not achieve a passing score, please click on the Posttest link in the left navigation bar and retake the exam.
3. After you complete the Evaluation, click on the Claim Credit button in the left navigation bar.
4. For CME credit, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim.
5. For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
6. For ECME credit, click the Claim button in the row for EMCE. Please note that you may only claim once for this activity. Enter date of birth and click Submit.
7. The page will be updated with the date and time that you claimed your credit.
8. To view your credit, or to print a certificate, please go to ACC.org and navigate to the My Transcript section of My ACC.

This CME/MOC/ECME-certified activity may contain links to other educational resources such as clinical trial summaries, journal articles, guidelines, etc., that may not be CME/MOC/ECME certified. Please note that clicking on the links provided to view these resources will open new windows, which are outside of this CME/MOC/ECME-certified activity.