Diabetes

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  • Type 2 diabetes is a major risk factor for the development of cardiovascular disease and cerebrovascular incidents. A substantial body of evidence has demonstrated that the proper management of blood glucose in people with diabetes can inhibit the progression of microvascular diseases such as retinopathy and nephropathy.

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    Type 2 diabetes is a major risk factor for the development of cardiovascular disease and cerebrovascular incidents. A substantial body of evidence has demonstrated that the proper management of blood glucose in people with diabetes can inhibit the progression of microvascular diseases such as retinopathy and nephropathy.

    In the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the overall mortality significantly increased by strict control of blood glucose (target HbA1c <6%) compared with a less stringent control (target HbA1c of approximately 7%). Strict glucose control resulted in a significantly higher likelihood of developing severe hypoglycaemia, while severe hypoglycaemia was itself associated with death due to CVD.

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Type 2 Diabetes (T2D)

Type 2 Diabetes Mellitus

CV Outcomes in Diabetes

Risk reduction with antihyperglycemics

Cardiovascular (CV) disease remains the leading cause of morbidity and mortality in patients with type 2 diabetes (T2D).

The opportunity for CV disease prevention in patients with T2D has recently expanded with antihyperglycemic agents demonstrating significant reductions in the risk of major adverse cardiovascular events (MACE). Although the exact mechanisms of CV benefit remain uncertain, they appear to be unrelated to the direct glucose-lowering effects. These agents have triggered a shift beyond glucose control, to a broader strategy of comprehensive CV risk reduction.

CV specialists are well-positioned to play a key role in managing patients with T2D including screening, aggressively treating CV risk factors, and incorporating the use of antihyperglycemic agents into routine practice.

novo nordisk

The Radcliffe diabetes and CVD risk program is supported by an educational grant from Novo Nordisk.

Section advisor

Prof Carolyn Lam Su Ping

National Heart Centre Singapore

Duke-NUS, University Medical Centre Groningen, The George Institute for Global Health

  • Type 2 Diabetes Mellitus and Heart Failure
    Shannon M. Dunlay, Michael M. Givertz, David Aguilar, et al

    This scientific statement on diabetes mellitus and heart failure summarizes the epidemiology, pathophysiology, and impact of diabetes mellitus and its control on outcomes in heart failure; reviews the approach to pharmacological therapy and...

    Circulation. 2019; 139:00–00. DOI: 10.1161/CIR.0000000000000691
  • Comparison of the Effects of Glucagon-Like Peptide Receptor Agonists
    Thomas A Zelniker, Stephen D. Wiviott, Itamar Raz, et al

    Glucagon-like peptide 1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) have emerged as 2 new classes of antihyperglycemic agents that also reduce cardiovascular risk.

    BACKGROUND:
    Glucagon-...

    Circulation. 2019 Apr 23;139(17):2022-2031.
  • Type 2 diabetes and risk of heart failure
    Dario Giugliano, Maria Ida Maiorino, Miriam Longo, et al

    Recognizing that 12 CVOTs have been completed, we planned a systematic review and meta-analysis of CVOTs that evaluated the effect of GLP-1 RAs, DPP-4i, and SGLT2i on HF risk in patients with T2D.

    AIM:
    We performed...

    Endocrine. 2019 Apr 26.
  • Comparative outcomes of heart failure
    Da-ya Yang, Xin He, Hui-wei Liang, et al

    In terms of heart failure risk, sodium-glucose co-transporters 2 were the most favorable option among all classes of anti-diabetic medications.

    BACKGROUND:
    The cardiovascular (CV) safety in terms of heart failure among...

    Cardiovasc Diabetol. 2019 Apr 8;18(1):47.

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Guidelines

The Role of Inflammation in Diabetes: Current Concepts and Future Perspectives

Open access
This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.

Diabetes is a multifaceted metabolic disorder affecting the glucose status of the human body. Impaired glucose tolerance and hyperglycaemia are the main clinical and diagnostic features and the result of an absolute or relative insulin deficiency or resistance to its action.

Sodium–glucose Cotransporter 2 Inhibitors in Heart Failure: Potential Mechanisms of Action, Adverse Effects and Future Developments

Open access
This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.

Type 2 diabetes (T2D) remains a major cardiovascular (CV) risk factor1–5 and it confers an approximately two- to threefold fold excess risk for coronary heart disease, including MI, stroke and heart failure (HF) in patients with and in patients without established cardiovascular disease (CVD).1,6–8 The prevalence of T2D among patients with HF is as high as 40–45% and that of HF in patients with T2D is reported to be 10–23%.8 Patients wit

Everything in Moderation: Investigating the U-Shaped Link Between HDL Cholesterol and Adverse Outcomes

Open access
This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.

Historically, HDL cholesterol (HDL-C) has been inversely associated with adfverse cardiovascular outcomes such as MI, stroke, and cardiovascular death.1–3 This led to widespread belief that HDL-C, in addition to LDL cholesterol (LDL-C), was a modifiable risk factor for cardiovascular disease.