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What is already known on this topic Glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors reduce the risk of cardiovascular and renal events in patients with type 2 diabetes These drug classes are increasingly used in combination when previous therapy with other antihyperglycaemic drugs fails Whether the combined use of these drug classes results in improved cardiovascular and renal outcomes in the real world setting, compared with the use of either drug class alone, remains unclear What this study adds This population based cohort study aimed at emulating a randomised controlled trial The combined use of a GLP-1 receptor agonist and an SGLT-2 inhibitor was associated with a lower risk of cardiovascular and serious renal events, compared with either drug class alone These findings highlight the potential benefit of combining these two effective drug classes in preventing cardiovascular and renal events in the treatment of type 2 diabetes Data availability statement This study is based on data from the Clinical Practice Research Datalink obtained under license from the UK Medicines and Healthcare products Regulatory Agency

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Suppressing glucagon, a hormone that raises blood glucose

Generally, pinching the skin gently creates a fold of subcutaneous tissue, which helps ensure the medication is delivered into fat rather than muscle

The SLC3 and SLC7 families of amino acid transporters

Isolation and characterization of E-64, a new thiol protease inhibitor