Abstract / Summary
Type 2 diabetes (T2DM), obesity, chronic kidney disease (CKD), and heart failure (HF) pose a major public health burden in Chile and Latin America. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) provide glycemic, cardiovascular, renal, and weight-loss benefits, extending their therapeutic role beyond glycemic control.
Aim: To develop a national consensus, based on GRADE methodology, that synthesizes the best available evidence and adapts it to the Chilean healthcare context, providing practical recommendations for the rational use of GLP-1 RA (GLP-1 receptor agonists).
Methods: A multidisciplinary panel convened by six Chilean scientific societies developed this consensus, using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. A systematic review of randomized trials and meta-analyses was conducted. Evidence tables were prepared and critically appraised to support transparent recommendations adapted to the Chilean healthcare context.
Results: The panel formulated seven key recommendations: (1) a strong recommendation for GLP-1 RAs in patients with T2DM and CKD; (2) a weak recommendation in CKD without diabetes; (3) a strong recommendation in T2DM with high cardiovascular risk; (4) a weak recommendation over sulfonylureas as add-on to metformin; (5) a strong recommendation in HF with preserved ejection fraction (HFpEF) and BMI ≥27; (6) a strong recommendation in obesity with T2DM; and (7) a weak recommendation in obesity without T2DM.
Conclusions: This consensus synthesizes international evidence and contextualizes it to Chile, supporting rational, equitable, and transparent implementation of GLP-1 RAs. These agents are positioned as central tools in the management of the cardiorenal-metabolic syndrome, complementing current cost-effective therapies and lifestyle interventions.