For the first time in many years, guideline-directed drug therapies have emerged that offer substantial cardiorenal benefits, improved quality of life and longevity in patients with chronic kidney disease (CKD) and type 2 diabetes. These treatment options include sodium-glucose cotransporter-2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists and glucagon-like peptide-1 receptor agonists. However, despite compelling evidence from multiple clinical trials, their uptake has been slow in routine clinical practice, reminiscent of the historical evolution of angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker use. The delay in implementation of these evidence-based therapies highlights the many challenges to optimal CKD care, including: (i) clinical inertia; (ii) low CKD awareness; (iii) suboptimal kidney disease education among patients and providers; (iv) lack of patient and community engagement; (v) multimorbidity and polypharmacy; (vi) challenges in the primary care setting; (vii) fragmented CKD care; (viii) disparities in underserved populations; (ix) lack of public policy focused on health equity; and (x) high drug prices. These barriers to optimal cardiorenal outcomes can be ameliorated by a multifaceted approach, using the Chronic Care Model framework, to include patient and provider education, patient self-management programs, shared decision making, electronic clinical decision support tools, quality improvement initiatives, clear practice guidelines, multidisciplinary and collaborative care, provider accountability, and robust health information technology. It is incumbent on the global kidney community to take on a multidimensional perspective of CKD care by addressing patient-, community-, provider-, healthcare system- and policy-level barriers.

UNASSIGNED: According to the requirements of the \"Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions\", this health technology assessment provides an evidence-based basis for drug selection and rational clinical use of glucagon-like peptide-1 receptor agonist drugs in medical institutions.
UNASSIGNED: We consult the drug instructions, clinical treatment guidelines and search relevant documents in databases such as China national knowledge infrastructure, Wanfang, PubMed, and government websites such as National Medical Products Administration, Food and Drug Administration, European Medicines Agency, and Pharmaceuticals and Medical Devices Agency to collect and sort out the relevant information of the indications, pharmacological effects, guideline recommendations, drug prices and other information of glucagon-like peptide-1 receptor agonists, using a percentile system systematically evaluate the five dimensions of glucagon-like peptide-1 receptor agonists in terms of pharmaceutical properties, efficacy, safety, economy, and other attributes.
UNASSIGNED: The final scores of the evaluation results from high to low are semaglutide (71.00 points), dulaglutide (68.75 points), liraglutide (67.50 points), exenatide (67.00 points), lixisenatide (63.50 points), polyethylene glycol loxenatide (58.00 points) and benaglutide (49.00 points).
UNASSIGNED: In clinical practice, semaglutide and dulaglutide are the top two drugs that can be used as recommended drugs. This health technology assessment can provide an evidence-based basis for hospital selection and rational use of glucagon-like peptide-1 receptor agonists. Clinicians can rationally choose and use drugs according to the patient\'s conditions and needs.

Glucagon-like peptide-1 receptor agonists (GLP-1RA) not only significantly lower blood glucose but also reduce multiple cardiovascular risk factors. Moreover, some of this class of anti-diabetic drugs have been shown to have beneficial effects in cardiovascular outcome trials. This expert consensus is developed for the optimal use of GLP-1RA in individualized treatment of type 2 diabetes mellitus (T2DM) and includes the timing of GLP-1RA use in the glucose-lowering therapeutic algorithm, the precautions while combined with other anti-diabetic drugs, the therapeutic benefits while preferably added on the anti-diabetic therapies for patients with T2DM and atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or chronic kidney disease (CKD), and the use of GLP-1RA in special population of patients with T2DM.
胰高糖素样肽-1受体激动剂（GLP-1RA）不仅显著降低2型糖尿病（T2DM）患者的血糖，还可以改善多种心血管危险因素，部分GLP-1RA被证实具有明确的心血管保护作用。本共识针对GLP-1RA降糖治疗的应用时机，与其他降糖药物联用时的注意事项，对T2DM合并动脉粥样硬化性心血管疾病（ASCVD）、心力衰竭（HF）或慢性肾脏疾病（CKD）患者治疗结局的影响，在T2DM特殊人群中的应用等临床问题给出了具体的推荐意见。.