Risk factor reduction in type 2 diabetes demands a multifactorial approach

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Dysglycaemia, including type 2 diabetes mellitus and impaired glucose tolerance, is prevalent in cardiovascular disease patients.
• Hyperglycaemia is a known link, but diabetes involves complex factors like insulin resistance, endothelial dysfunction, hypertension, and dyslipidaemia.
• Despite advances, a significant residual risk for cardiovascular complications persists in patients with dysglycaemia.

Purpose of the Study:

• To provide a comprehensive overview of improving prognosis for patients with dysglycaemia.
• To detail multifactorial management strategies based on 2019 European guidelines.
• To highlight recent therapeutic advancements and their cardiovascular benefits.

Main Methods:

• Review of recent clinical trial data on glucose-lowering agents.
• Analysis of European Society of Cardiology and European Association for the Study of Diabetes guidelines (2019).
• Synthesis of current understanding of diabetes pathophysiology and cardiovascular risk factors.

Main Results:

• Sodium-glucose-transporter 2 (SGLT2) inhibitors show benefits in reducing heart failure.
• Glucagon-like peptide 1 (GLP-1) receptor agonists may slow atherosclerotic vascular disease progression.
• Multifactorial management, including lifestyle adjustments and blood pressure, lipid, and glucose control, is crucial.

Conclusions:

• Improved management and novel therapeutic opportunities are essential to address the residual cardiovascular risk in dysglycaemia.
• SGLT2 inhibitors and GLP-1 receptor agonists offer beneficial effects on cardiovascular prognosis and mortality.
• A multifactorial approach, integrating guideline-based strategies and new drug classes, is key to enhancing outcomes for patients with dysglycaemia.