Understanding the cardiovascular risk with non-insulin antidiabetic drugs.

Disparities in cardiovascular safety and efficacy between antidiabetic drugs exist. Metformin remains the first-choice drug with proven cardiovascular benefits. The cardiovascular profile of sulfonylureas is yet unclarified, while thiazolidinediones seem to be effective in secondary stroke prevention but heart failure concerns limit their use. The cardiovascular safety of DPP-4 inhibitors has been demonstrated, without however significant morbidity and mortality benefits. SGLT-2 inhibitors and GLP-1 analogues offer significant cardiovascular benefits and are recommended for patients with overt cardiovascular disease.