Diabetes and Cardiovascular Disease: an Update
Rajaa Almourani1, Bhavana Chinnakotla1, Richa Patel1
1Department of Medicine, Division of Endocrinology, University of Missouri, Columbia, MO, USA.
Current Diabetes Reports
|December 13, 2019
Summary
Cardiovascular disease is a major risk for people with diabetes. Managing diabetes requires focusing on cardiovascular risk reduction with glucose-lowering agents and other therapies, not just glycemic control.
Area of Science:
- Endocrinology
- Cardiology
- Pharmacology
Background:
- Cardiovascular disease (CVD) is the primary cause of death in individuals with diabetes.
- Effective management strategies for diabetes must address the high risk of CVD.
Purpose of the Study:
- To review the pathophysiology of CVD in diabetes.
- To examine landmark clinical trials related to CVD in diabetes.
- To discuss the cardiovascular benefits of glucose-lowering agents and anti-platelet therapies.
Main Methods:
- Literature review of pathophysiology.
- Analysis of landmark clinical trials.
- Discussion of current treatment guidelines and emerging evidence.
Main Results:
- Statins are recommended for all diabetic patients over 40, irrespective of LDL levels, due to proven cardiovascular benefits.
- Blood pressure targets below 130/80 mmHg are advised for high-risk individuals.
- Multifactorial risk reduction, including lipid-lowering and antihypertensive agents, is crucial.
Conclusions:
- Glycemic control alone is insufficient for optimal diabetes management.
- Glucose-lowering agents with demonstrated cardiovascular benefits should be initiated early.
- Comprehensive cardiovascular risk reduction is essential for patients with diabetes.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
819
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
819
01:15Diabetes: Management and Pharmacotherapy
807
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
807
01:22Diabetes Mellitus: Type 2 and Gestational
4.2K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.2K
01:22Diabetes Mellitus: Overview and Type I Subtype
4.7K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.7K
01:20Pathophysiology of Diabetes
3.0K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
3.0K
01:15Diabetes: Symptoms, Diagnosis, and Complications
1.9K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
1.9K