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.
Load moreType 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 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.
Section Editor
Saint Luke's America Heart Institute, Kansas City, MO, US
Clinical publications
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McMurray JJV, DeMets DL, Inzucchi SE, et al. Eur J Heart Fail 2019;21:1402–11.
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Shen L, Rørth R, Cosmi D, et al. Eur J Heart Fail 2019;21:974–84.
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Abraham WT, Ponikowski P, Brueckmann M, et al. Eur J Heart Fail 2019;21:932–42.
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Aroda VR, Ahmannb A, Cariou B, et al. Diabetes Metab 2019;45:409–18.
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Amod A, Buse JB, McGuire DK, et al. Diabetes Ther 2020;11:53–70.
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Jensen J,Omar M, Kistorp C, et al. Trials 2019;20:374.
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Ongoing trials
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Review articles
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Khan SU, Ul Abideen Asad Z, Khan MU, et al. Eur J Prev Cardiol 2019; epub ahead of press.
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Verma S, Jüni P, Mazer CD. Lancet 2019;393:3–5.
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