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
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Thomas A Zelniker, Stephen D Wiviott, Itamar Raz, et alSGLT2i 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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Clinical publications
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Pratley RE, Husain M, Lingvay I, et al. Cardiovasc Diabetol 2019;18:156.
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Coleman RL, Grab AM, Broedl UC, et al. Diabetes Obes Metab 2020; epub ahead of press.
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Bajaj HS, Raz I, Mosenzon O, et al. Diabetes Obes Metab 2020; epub ahead of press.
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Verma S, Ji Q, Bhatt DL, et al. Diabetes Obes Metab 2020; epub ahead of press.
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Idzerda NMA, Clegg LE, Hernandez AF, et al. Diabetes Obes Metab 2020;22:798–806.
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Dawwas GK, Leonard CE, Garg M, et al. Diabetes Obes Metab 2020;22:705–10.
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Ongoing trials
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Review articles
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Cherney DZ, Odutayo A, Aronson R, et al. J Am Coll Cardiol 2019;74:2511–24.
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Baker ML, Perazella MA. J Nephrol 2020; epub ahead of press.
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Lee MMY, Petrie MC, McMurray JJV, Sattar N. Arterioscler Thromb Vasc Biol 2020;40:506–22.
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Giorgino F, Caruso I, Moellmann J, Lehrke M. Metabolism 2020;104:154045.
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El Aziz MA, Cahyadi O, Meier JJ, et al. Diabetes Obes Metab 2020;22:699–704.
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Giugliano D, Ceriello, A, De Nicola, L, et al. Diabetes Obes Metab 2020;22:149–57.
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Guidelines
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Congress Updates
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Zinman B, Fitchett DH, Mattheus M, et al. Diabetes 2019;68(Suppl 1):159-LB.
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Frias JP, Evenou P, Dalton D, Dungan KM. Diabetes 2019;68(Suppl 1):128-LB.
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Rosenstock J, Allison DC, Birkenfeld AL, et al. Diabetes 2019;68(Suppl 1):111-LB.
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Nakaguchi H, Kondo Y, Terauchi Y. Diabetes 2019;68(Suppl 1):113-LB.
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Iglay K, Bansal N, Gulati T, et al. Diabetes 2019;68(Suppl 1):2352-PUB.
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Jeong SJ, Park IEB, Lee SE, et al. Diabetes 2019;68(Suppl 1):2346-PUB.
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