Diabetes

About

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 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

Prof Carolyn Lam Su Ping

National Heart Centre Singapore

Duke-NUS, University Medical Centre Groningen, The George Institute for Global Health

The Evolving Role of the Cardiologist in the...

Robert Chilton, Kelly M. Gallegos, José Silva Cardoso, et al

PURPOSE OF REVIEW: To evaluate the treatment of type 2 diabetes from a cardiologist’s view.

RECENT FINDINGS: A new era in the treatment of type 2 diabetes began for the cardiologist in 2015 with the...

Curr Diab Rep. 2018 Nov 8;18(12):144.
Glucagon-Like Peptide-1 Receptor Agonists and...

Yixing Li, Paul D. Rosenblit

PURPOSE OF REVIEW: Mimetics and analogs that extend the half-life of native glucagon-like peptide-1 (GLP-1), i.e., glucagon-like peptide-1 receptor agonists (GLP-1 RAs), at therapeutic doses, are indicated as adjuncts to diet and...

Curr Cardiol Rep. 2018 Sep 26;20(11):113
Cardiovascular outcome studies in type 2 diabetes...

André J. Scheen

Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are two pharmacological classes that have proven their efficacy to reduce major cardiovascular events (MACEs) in patients with type...

Diabetes Res Clin Pract. 2018 Sep;143:88-100.