Diabetes

  • 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.


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

novo nordisk

Section Editor

Professor Mikhail N Kosiborod

Saint Luke's America Heart Institute, Kansas City, MO, US

  • Issues of cardiovascular risk management

    People with diabetes have a worse prognosis with COVID-19. The disease’s complex pathology may be a challenge for the use of most diabetes medications, due to emerging contraindications that need close monitoring in SARS-CoV-2 infection.

    Ceriello A, Standl E, Catrinoiu D, et al. Diabetes Care 2020;43:1427–32.
  • Cardiovascular risk reduction with liraglutide

    The authors identifed HbA1c and urinary albumin:creatinine ratio as potential mediators of the CV effects of liraglutide. These findings warrant further investigation.

    Buse JB, Bain SC, Mann JFE, et al. Diabetes Care 2020;43:1546–52.
  • LEADER trial eligibility and preventable cardiovascular

    Liraglutide may prevent many fatal and non-fatal CVD events if provided to US adults meeting LEADER eligibility criteria. More efforts are needed to educate healthcare providers on the CVD benefits of newer diabetes therapies.

    Fan W, Tong C, Wong ND. Cardiovasc Drugs Ther 2020; epub ahead of press.
  • Superior effect of 1-year treatment

    Researchers investigated weight loss with liraglutide, exercise and both in obese individuals after a very low-calorie diet. Liraglutide and exercise was superior to either alone in weight loss maintenance and further reduction.

    Janus C, Lundgren JR, Jensen S, et al. Diabetes 2020;69(Suppl1):139-OR.

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