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

  • SGLT2 Inhibitors
    Subodh Verma, Peter Jüni, C David Mazer, et al

    Concerns about the growing burden of diabetes are mounting. 1 Temporal analyses suggest that cardiovascular risk in people with diabetes persists and, if anything, is widening for fatal outcomes. 2 The need for interventions to prevent diabetes-...

    Lancet (London, England), ISSN: 1474-547X, Vol: 393, Issue: 10166, Page: 3-5
  •  Type 2 Diabetes risks
    Francesco Cosentino, Antonio Ceriello, Florian M M Baeres, et al

    Type 2 diabetes mellitus (T2DM) is a recognized risk factor for cardiovascular (CV) disease (CVD). In a large, prospective, cohort study of individuals ≥30 years of age, 18% of patients with diabetes developed incident CVD over 5.5 years of...

    Roundtable, European Heart Journal, , ehy677.
  • Type 2 Diabetes & Atherosclerotic CVD
    Sandeep R. Das, Brendan M. Everett, Kim K. Birtcher, et al

    Despite major therapeutic advances leading to improved outcomes over the past 2 decades, cardiovascular (CV) disease remains the leading cause of morbidity and mortality in patients with type 2 diabetes (T2D) (1). Over that time, the prevalence...

    Journal of the American College of Cardiology, ISSN: 1558-3597, Vol: 72, Issue: 24, Page: 3200-3223
  • CVD & Renal Outcomes In Type 2 Diabetes
    Thomas A Zelniker, Stephen D. Wiviott, Itamar Raz, et al

    SGLT2i have moderate benefits on atherosclerotic major adverse cardiovascular events that seem confined to patients with established atherosclerotic cardiovascular disease. However, they have robust benefits on reducing hospitalisation for heart...

    Lancet (London, England), ISSN: 1474-547X, Vol: 393, Issue: 10166, Page: 31-39

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Ongoing trials

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Guidelines

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.

Diabetic Cardiomyopathy: Five Major Questions with Simple Answers

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 is a major risk factor for the development of heart disease.1 At the beginning of the last century, or even before, several authors described a possible association between diabetes and heart failure (HF).2 However, according to the Heart Failure Association of the European Society of Cardiology guideline for the treatment of type 2 diabetes and HF, the first report of this association, excluding other risk factors, was published in 1954.