New diabetes treatments: what do we have and what is accessible in Latin America?

Abstract

For decades, type 2 diabetes mellitus (T2DM) management focused mainly on glycemic control. However, cardiovascular outcome trials (CVOTs), mandated since 2008, shifted this paradigm by demonstrating that therapeutic success must be evaluated through cardiorenal-metabolic risk reduction.

Classes such as SGLT2 inhibitors, GLP-1 receptor agonists, and dual GIP/GLP-1 receptor agonists have revolutionized T2DM care. Accumulating clinical evidence shows benefits far beyond glucose lowering, including reductions in major adverse cardiovascular events, heart failure hospitalizations, chronic kidney disease progression, and significant weight loss. Consequently, treatment selection should be tailored to individual patient phenotypes and specific comorbidities.

In Latin America, this progress introduces a major challenge: translating clinical evidence into real-world patient access. Regulatory heterogeneity, high costs, coverage gaps, and healthcare disparities prevent these high-value therapies from reaching those who need them most.

The primary obstacle in the region is not merely the availability of advanced molecules, but the implementation of accessible, sustainable, and equitable healthcare strategies. The cardiorenal-metabolic paradigm reaches its full potential only when evidence-based therapies arrive promptly and equitably to transform patient outcomes across Latin America.