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Importantly, payer reimbursement restrictions are probably in place because previous cost-effectiveness analyses of these medications have considered at least some measure of their glycaemic benefits [13, 14], while whether SGLT2is and GLP-1 RAs are cost-effective solely on the basis of their benefits on cardiovascular and kidney disease has never been studied as far as we are aware

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A Cornerstone for Cardio-Renal-Metabolic Care For patients with diabetes or CKD, GLP-1 therapies deliver benefits that extend well beyond weight loss: Direct Kidney Protection GLP-1 receptor activation can: Lower intraglomerular pressure Promote natriuresis Reduce activity of the renin-angiotensin-aldosterone system Limit renal inflammation, oxidative stress and fibrosis These mechanisms collectively slow CKD progression and help preserve renal function

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