Investor Presentation
34
Investor presentation
First six months of 2022
Novo NordiskⓇ
Class
Efficacy
Hypo Weight
risk
Cardiovascular effects
change
ASCVD
HF
Metformin
High
No Neutral
Potential
Benefit
Neutral
GLP-1s have positive effects beyond glycaemic control and
treatment guidelines now reflect the CV risk benefits
Medications for treatment of type 2 diabetes
ADA/EASD diabetes treatment guidelines for second-line
treatment with established ASCVC or CKD
First-line therapy is metformin and lifestyle management.
If HbA₁ above target, proceed as below
NO
Without
established
ASCVD or CKD
Established ASCVD or CKD
Sulfonylurea
High
Yes
Gain
Neutral
Neutral
YES
ASCVD predominates
TZDS
High
No
Gain
Potential
Benefit
Increased risk
HF OR CKD
predominant
DPP-IV
inhibitors
SGLT-2
inhibitors
Intermediate No Neutral
Neutral
Potential risk
GLP-1
with proven CVD
benefit*
Intermediate No
Loss
Benefit
Benefit
EITHER/OR
SGLT-2
with proven CVD
benefit*,
if eGFR adequate
Benefit/
GLP-1
High
No
Loss
Neutral
Neutral1
Long-acting
High
Yes
Gain
Neutral
Neutral
insulin
Fast-acting
insulin
High
Yes
Gain
Neutral
Neutral
If HbA1c above target
If further intensification is required or patient is now unable to
tolerate GLP-1 and/or SGLT-2, choose agents demonstrating CV safety
1 Benefit: dulaglutide, liraglutide, semaglutide; Neutral: exenatide once weekly, lixisenatide
Hyp: Hypoglycaemia; ASCVD: Atherosclerotic cardiovascular disease; HF: Heart failure: TZDS: Thiazolidinediones
Source: Adapted from: "Standards of Medical Care in Diabetes - 2022" Supplement 1, p.133; diabetes.org. American Diabetes
Association.
Sources: Adapted from: Nathan DM, et al. Diabetes Care. 2006; 29: 1963-1972; Nathan DM, et al. 2007;30:753-
759; Nathan DM, et al. Diabetes Care. 2008;31:173-175. ADA. Diabetes Care. 2008; 31:S12-S54. WelChol PI.
1/2008. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes
Association (ADA) and the European Association for the Study of Diabetes (EASD)View entire presentation