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.


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

  • Dapagliflozin in Patients with HF and HFrEF

    This method paper details the DAPA-HF trial. The ground-breaking DAPA-HF trial showed that among patients with HF and a HFrEF, those who received the SGLT2i dapagliflozin had a lower risk of worsening HF or death from CV causes, regardless of the...

    McMurray JJV, Solomon SD, Inzucchi SE, et al. N Engl J Med 2019;381:1995–2008.
  • Cardio-diabetology: The new ‘sweetheart’ in cardiovascular prevention

    This special issue accompanies the cardiovascular specialists from the pre-diabetic state to the holistic approach of the management of diabetes and the metabolic syndrome up to the management of those experiencing a cardiovascular event.

    Aboyans V, Cosentino F. Eur J Prev Cardiol 2019;26(2 Suppl):5–6.
  • GLP-1RA for prevention of CR outcomes in T2D

    This meta-analysis of GLP-1RA CVOTs sheds new light on the cardiorenal efficacy of GLP-1RAs in patients with T2D.

    Giugliano D, Maiorino MI, Bellastella G, et al. Diabetes Obes Metab 2019;21:2576–80.
  • CV Outcome Trials in T2D

    This review explores SGLT2 and GLP-1RA study designs and CV outcome trials and their impact on clinical practice.

    Eckel RH, Farooki A, Henry RR, et al. Clin Diabetes 2019;37:316–37.

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