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Competing Interests The authors declare no competing interests

Prebiotic mannan-oligosaccharides augment the hypoglycemic effects of metformin in correlation with modulating gut microbiota
placebo in the fall of eGFR was better among patients with macroalbuminuria or in those with eGFR between 3060 ml/min/1.73 m2,100 and in the AWARD-7 trial the effect of dulaglutide on renal clinical outcomes and eGFR decline was more pronounced in participants with macroalbuminuria at baseline.66 Likewise, in a post hoc analysis of the LEADER study those patients who experienced a 30% reduction in albuminuria during follow-up had fewer cardiovascular and renal events,101 which confirms that a reduction in albuminuria is associated with a reduction in cardiovascular and renal events.99,102 Finally, the renal benefits of arGLP-1 appear to be additive to those of iSGLT2, which is of particular interest in patients with DKD.85,86,103 Cardiovascular and renal benefits of these drugs have been also demonstrated in real-life studies.104105 The causes of renal protection by some arGLP-1 s are unclear

Salah K, Stienen S, Pinto YM et al (2019) Prognosis and NT-proBNP in heart failure patients with preserved versus reduced ejection fraction
