Diabetes
About
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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 advisor
National Heart Centre Singapore
Duke-NUS, University Medical Centre Groningen, The George Institute for Global Health
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Clinical publications
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Stephen D Wiviott, Itamar Raz, Ofri Mosenzon, et alN Engl J Med. 2018 Nov 10. (ahead of print)
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Deepak L. Bhatt, Philippe Gabriel Steg, Michael Miller, et alN Engl J Med. 2018 Nov 10.
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Michael E Farkouh, Michael Domanski, George D Dangas, et alJ Am Coll Cardiol. 2018 Nov 1. pii: S0735-1097(18)38994-0.
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Paul M Ridker, Brendan M. Everett, Aruna Pradhan, et alN Engl J Med. 2018 Nov 10.
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Adrian F Hernandez, Jennifer B Green, Salim Janmohamed, et alLancet. 2018 Oct 1. pii: S0140-6736(18)32261-X.
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Benjamin M. Scirica, Silvio E Inzucchi, Darren K. McGuire, et alLancet. 2018 Oct 3. pii: S0140-6736(18)32328-6.
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Ongoing trials
Review articles
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Guidelines
Congress Updates
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S Verma, L A Leiter, C D Mazer, et al
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R J Mentz, V P Thompson, S M Gustavson, et al
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Kausik K Ray, Helen Colhoun, Michael Szarek, et al
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Silvio E Inzucchi, Catherine M Viscoli, Lawrence H Young, et al
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Suzanne V Arnold, Phillip R Hunt, Hungta Chen, et al
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Raymond Townsend, Mala Dharmalingam, Stefano Genovese, et al
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