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

  • Comparative outcomes of heart failure

    In terms of heart failure risk, sodium-glucose co-transporters 2 were the most favorable option among all classes of anti-diabetic medications.

    BACKGROUND:
    The cardiovascular (CV) safety in terms of heart failure among...

    Yang D, He X, Liang H, et al. Cardiovasc Diabetol 2019;18:47.
  •  Type 2 Diabetes risks

    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...

    Cosentino F, Ceriello A, Baeres FMM, et al. Eur Heart J 2019;40:2907–19.
  • Type 2 Diabetes & Atherosclerotic CVD

    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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Statins and Insulin Resistance

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Statins are lipid-lowering drugs that are beneficial for the cardiovascular system. However, they are associated with skeletal muscle disorders and, recently, with insulin resistance and new-onset diabetes. To date, mechanisms underlying statin-induced insulin resistance are not fully elucidated.

The goals of the study were to characterise effects of simvastatin on glucose metabolism and processes leading to the induced insulin resistance in skeletal muscle cells and mice.

Protocol of a Randomised, Single Blind, Placebo-controlled RESCAP Intervention Study to Determine the Safety of RESCAP in Diabetes: RAPID Protocol – Rationale and Design

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Type 2 diabetes (T2D) affects 5.3% of the world’s population and has a huge impact on healthcare costs, morbidity and mortality. Low-grade chronic systemic inflammation results in complications, such as retinopathy, end-stage renal disease, diabetic wounds and pregnancy complications. Alkaline phosphatase (AP) supplementation restores insulin and blood-lipid chemistry in preclinical models. A human field study in T2D patients reported that AP in faeces is reduced 50%.

We propose oral AP supplementation in T2D patients.

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