SGLT2 Inhibitors As First Line Therapy to Prevent Renal Decline in Type 2 Diabetes

Inclusion Criteria:

• Diagnosis of T2D;

• Aged ≥18 years;

• Body mass index > 18.5 kg/m2;

• Drug naïve, or managed with metformin monotherapy and willing to be randomised toeither dapagliflozin or metformin;

• eGFR ≥45 ml/min/1,73m2; and

• Signed informed consent.

Exclusion Criteria:

• Have an immediate need for rapid intensification of glucose lowering therapy due tomarked hyperglycaemia; or

• There is a definite indication for, or contraindication to, either metformin orSGLT2 inhibitor; or

• They have clearly documented coronary artery disease (defined as a previous acutecoronary syndrome, coronary stent or bypass surgery) or clearly documented heartfailure (defined on the basis of a hospital admission, specialist diagnosis or anechocardiogram or other imaging modality); or

• Pregnant or breast-feeding.