Diabetes, prediabetes and cardiovascular risk

Area of Science:

• Endocrinology
• Cardiology
• Public Health

Background:

• Rising incidence of diabetes and prediabetes, linked to cardiovascular disease (CVD), poses a significant public health challenge.
• Cardiovascular mortality and morbidity are increased by undetected glucose metabolism issues, including impaired glucose tolerance and diabetes.
• A gap exists in cardiologists' understanding of the prevalence and impact of glucose perturbations in CVD patients.

Purpose of the Study:

• To highlight the high prevalence of undiagnosed glucose perturbations in patients with coronary artery disease.
• To emphasize the need for routine screening of glucose metabolism in all cardiovascular disease patients.
• To advocate for integrated, multifactorial treatment strategies involving cardiologists and diabetologists.

Main Methods:

• Screening of patients with stable and unstable coronary artery disease using the oral glucose tolerance test.
• Analysis of the association between glucose perturbations and cardiovascular mortality/morbidity.
• Review of European guidelines for managing diabetes, prediabetes, and cardiovascular disease.

Main Results:

• Approximately two-thirds of coronary artery disease patients exhibit previously unknown impaired glucose tolerance or diabetes upon screening.
• Both impaired glucose tolerance and diabetes are independently associated with increased cardiovascular mortality and morbidity.
• Current cardiological practice often overlooks the necessity of aggressive management of underlying metabolic disorders.

Conclusions:

• Routine oral glucose tolerance testing is recommended for all patients with cardiovascular disease manifestations.
• Effective management requires a transprofessional collaboration between cardiologists and diabetologists.
• Target-driven, multifactorial treatment approaches are crucial for improving prognosis in patients with comorbid diabetes and cardiovascular disease.