Evaluating Cardio-Protective Molecules by Efficacy Based on Weight Reduction and HbA1c Targets

<b>Background</b>: The effectiveness of GLP-1 RAs and SGLT-2i classes, evaluated by a HbA1c target of <7% and body weight reduction (BWR) of 5% in patients with type 2 diabetes mellitus (T2DM), represents the aim of this article. <b>Methods</b>: A retrospective analysis was conducted on consecutively admitted out-patients of a tertiary care center for diabetes mellitus (DM) treatment from Romania, where 405 enrolled patients were evaluated at baseline, 6-, and 12-month visits. <b>Results</b>: SGLT-2i were superior to GLP-1 RAs and metformin, providing higher rates of combined target achievements-22.7% at 12 months, <i>p</i> < 0.001. Both HbA1c reduction and BWR were more consistent at the 12-month visit: 6.58% for metformin, 22.68% for SGLT-2i, and 5.88% for GLP-1 Ras, as compared to baseline while the 12-month visit results were as follows: 4.79% for metformin, 5.04% for SGLT-2i and 5.88% for GLP-1 RAs as compared to the 6-month visit. Despite the fact that the HbA1c < 7% target at baseline was 38.92% for metformin, 17.64% for SGLT-2i, and 41.17% for GLP-1 RAs, BWR was achieved less, probably influenced by insulin treatment. <b>Conclusions</b>: This study shows real-world Romanian efficacy and over the time response of administering the new classes in T2DM patients when aiming for HbA1c < 7% levels and 5% BWR, with SGLT-2i outperforming metformin and GLP-1 RAs, emphasizing their growing role in the management of T2DM.