GLP-1RAs and SGLT2i lack clear clinical evidence for diabetic neuropathy despite preclinical promise
Therapeutic potential of GLP-1 receptor agonists and SGLT2 inhibitors in diabetic neuropathy: a critical appraisal.
Background
Type 2 diabetes (T2D) management has evolved to prioritize cardiovascular and renal health beyond mere glycemic control. Despite this, diabetic neuropathy (DN) and associated neuropathic pain remain major complications, imposing considerable patient burden and mortality, with a significant unmet need for disease-modifying pharmacotherapies. While preclinical studies hint at the therapeutic potential of GLP-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in DN, large-scale cardiovascular outcome trials (CVOTs) have largely overlooked comprehensive neuropathy assessment, leaving a critical gap in clinical evidence.