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Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart
Cecilia C Low Wang1, Connie N Hess1, William R Hiatt1
1From Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado School of Medicine, Aurora (C.C.L.); CPC Clinical Research, Aurora, CO (C.C.L., C.N.H., W.R.H.); Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora (C.N.H., W.R.H.); Joslin Diabetes Center, and Harvard Medical School, Boston, MA (A.B.G.).
Circulation
|June 15, 2016
Summary
Cardiovascular disease is a major risk for people with diabetes mellitus. Current treatments improve outcomes but do not fully address the underlying mechanisms of heart disease in diabetic patients.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Cardiovascular disease (CVD) is the leading cause of death and disability in patients with diabetes mellitus.
- Diabetes mellitus accelerates atherosclerosis and heart failure, but current glycemic control strategies are insufficient.
- Despite multifactorial risk reduction, CVD complication rates remain elevated in diabetic populations.
Purpose of the Study:
- To review the mechanisms, historical context, and controversies in managing cardiovascular disease in diabetes mellitus.
- To evaluate new pharmacological agents and recent evidence for current cardiovascular management guidelines.
- To support evidence-based care for diabetic patients with heart disease outside acute settings.
Main Methods:
- Literature review of mechanisms, history, and controversies.
- Analysis of new pharmacological agents for diabetes and CVD.
- Examination of recent evidence and current guidelines for cardiovascular management.
Main Results:
- Existing therapeutic strategies inadequately modulate diabetes-exacerbated CVD mechanisms.
- Multifactorial risk reduction shows benefits but does not eliminate the elevated CVD risk in diabetes.
- New pharmacological agents and updated guidelines offer improved management options.
Conclusions:
- Optimal glycemic control alone is insufficient for preventing cardiovascular complications in diabetes mellitus.
- Comprehensive management addressing multifactorial risks is crucial.
- Evidence-based strategies, including novel agents, are essential for improving cardiovascular outcomes in diabetic patients.
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