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

  • 2019 ESC Guidelines on diabetes

    This is the third set of Guidelines produced by the ESC in collaboration with the EASD, designed to provide guidance on the management and prevention of cardiovascular (CV) disease (CVD) in subjects with, and at risk of developing, diabetes...

    Cosentino F, Grant PJ, Aboyans V, et al. Eur Heart J 2019;40:3215–7.
  • Type 2 Diabetes Mellitus and Heart Failure

    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...

    Dunlay SM, Givertz MM, Aguilar D, et al. Circulation 2019;140:e294–324.
  • 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.

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