Screening for and Aggressive Treatment of CVD Comorbidities Is Crucial in Patients With Type 2 Diabetes
All patients with type 2 diabetes should be systematically assessed for modifiable cardiovascular disease (CVD) risk factors, including hypertension, dyslipidemia, smoking, and sedentary lifestyle, and should receive aggressive treatment to improve all present comorbidities, according to Jennifer Marks, MD, who presented today at Consultant360’s Cardiometabolic Risk Summit 2019.
Jennifer B. Marks, MD, FACP, FACE, is professor emeritus at the University of Miami Miller School of Medicine and Diabetes Research Institute in Miami, Florida.
She started her session by highlighting the importance of the CVD risk associated with diabetes and its frequent comorbid conditions. Obesity/overweight, hypertension, and hyperlipidemia are the top 3 CVD comorbidities associated with diabetes. However, screening for these modifiable risk factors and prescribing lifestyle modification may be able to reduce the burden of these comorbidities.
Dr Marks then discussed current guideline recommendations to optimize antihyperglycemic therapy in patients with type 2 diabetes and outlined the benefits and risks of various classes of antihyperglycemic agents, including sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
Large CVD outcomes trials have shown that both SGLT2i and GLP-1 RAs are associated with significant reductions in CVD events in patients with increased risk for CVD, creating a paradigm shift in treatment strategies for patients with type 2 diabetes and atherosclerotic cardiovascular disease.
Both classes of agents also appear to have renal benefits. The mechanisms of action at the basis of CVD and renal benefits of SGLT2i and GLP-1 RAs are complex, multifactorial, and still not completely understood.
Dr Marks closed her session by recommending SGLT2i and GLP-1 RAs should be strongly considered after lifestyle modifications and metformin in appropriate at-risk patients.
Marks JB. Evolving considerations for the management of CV risk in patients with T2DM. Talk presented at: Consultant360’s Cardiometabolic Risk Summit 2019; October 24-26, 2019; Orlando, FL.