scholarly journals Underuse of Medications and Lifestyle Counseling to Prevent Cardiovascular Disease in Patients With Diabetes

Diabetes Care ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. e75-e76 ◽  
Author(s):  
Jonathan D. Newman ◽  
Jeffrey S. Berger ◽  
Joseph A. Ladapo
Keyword(s):  
Cardiovascular Disease ◽  
Lifestyle Counseling ◽  
Patients With Diabetes

scholarly journals Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Demetria Hubbard ◽  
Lisandro D. Colantonio ◽  
Robert S. Rosenson ◽  
Todd M. Brown ◽  
Elizabeth A. Jackson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
High Risk ◽  
Kidney Disease ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Very High

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

scholarly journals Effects of BMI and LDL-cholesterol change pattern on cardiovascular disease in normal adults and diabetics

2020 ◽  
Vol 8 (2) ◽  
pp. e001340
Author(s):  
Tae Mi Youk ◽  
Min Jin Kang ◽  
Sun Ok Song ◽  
Eun-Cheol Park
Keyword(s):  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Diabetic Control ◽  
Individual Variability ◽  
Control Group ◽  
Simple Method ◽  
Change Pattern ◽  
Patients With Diabetes ◽  
Variability Model

IntroductionTo examine how the risk of cardiovascular disease changes according to degree of change in body mass index (BMI) and low-density lipoprotein (LDL)-cholesterol in patients with diabetes using the health medical examination cohort database of the National Health Insurance Service in Korea. In comparison, the pattern in a non-diabetic control group was also examined.Research design and methodsThe study samples were 13 800 patients with type 2 diabetes and 185 898 non-diabetic controls, and their baseline characteristics and repeatedly measured BMI and LDL-cholesterol until occurrence of cardiovascular disease were collected in longitudinal data. We used the variability model that is joint of mixed effects and regression model, then estimated parameters about variability by Bayesian methods.ResultsThe risk of cardiovascular disease was increased significantly with high average real variability (ARV) of BMI in the patients with diabetes, but the risk of cardiovascular disease was not increased according to degree of ARV in non-diabetic controls. The Bayesian variability model was used to analyze the effects of BMI and LDL-cholesterol change pattern on development of cardiovascular disease in diabetics, showing that variability did not have a statistically significant effect on cardiovascular disease. This shows the danger of the former simple method when interpreting only the mean of the absolute value of the variation.ConclusionsThe approach of simple SD in previous studies for estimation of individual variability does not consider the order of observation. However, the Bayesian method used in this study allows for flexible modeling by superimposing volatility assessments on multistage models.

scholarly journals Association between plasma levels of heat shock protein 60 and cardiovascular disease in patients with diabetes mellitus

2006 ◽  
Vol 27 (13) ◽  
pp. 1565-1570 ◽  
Author(s):  
Alireza Shamaei-Tousi ◽  
Jeffrey W. Stephens ◽  
Ren Bin ◽  
Jacqueline A. Cooper ◽  
Andrew Steptoe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Plasma Levels ◽  
Heat Shock Protein 60 ◽  
Patients With Diabetes

Lipid Management with Statins in Type 2 Diabetes Mellitus

2005 ◽  
Vol 39 (10) ◽  
pp. 1714-1719 ◽  
Author(s):  
Brian K Irons ◽  
Lisa A Kroon
Keyword(s):  
Cardiovascular Disease ◽  
Relative Risk ◽  
Risk Reduction ◽  
Relative Risk Reduction ◽  
Data Extraction ◽  
Density Lipoprotein ◽  
Coronary Event ◽  
Lipid Management ◽  
Medline Search ◽  
Patients With Diabetes

OBJECTIVE: To provide an update on lipid management and recent modifications in cholesterol guidelines for use of hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), specifically in patients with diabetes. DATA SOURCES: Studies and guidelines were identified through a MEDLINE search (1996–April 2005). STUDY SELECTION AND DATA EXTRACTION: Studies were selected for review if the primary treatment intervention was a statin, at least 4% of the study population held a diagnosis of diabetes, and diabetes subgroup analysis was available. DATA SYNTHESIS: The Heart Protection Study demonstrated an approximately 25% relative risk reduction of a first coronary event in patients with diabetes, a reduction similar to those without diabetes. In subjects with diabetes, a significant reduction in coronary events was noted regardless of the baseline cholesterol level. The Collaborative Atorvastatin Diabetes Study demonstrated a 37% relative risk reduction in the primary prevention of cardiovascular morbidity in patients with diabetes. CONCLUSIONS: Based on the current literature, a low-density lipoprotein cholesterol (LDL-C) level <100 mg/dL remains an appropriate goal for patients with diabetes in the absence of established cardiovascular disease. For higher-risk patients, such as those with diabetes and a history of cardiovascular disease, a more stringent LDL-C goal of <70 mg/dL is an option according to current clinical trial evidence. At least a 30–40% reduction in the LDL-C level is advisable when initiating statin therapy.

Abstract 086: Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes: International Insights From the TECOS Trial

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Neha J Pagidipati ◽  
Ann Marie Navar ◽  
Karen S Pieper ◽  
Jennifer B Green ◽  
M. A Bethel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Latin America ◽  
North America ◽  
Secondary Prevention ◽  
Eastern Europe ◽  
Statin Therapy ◽  
Smoking Status ◽  
Pressure Control ◽  
Patients With Diabetes

Background: Intensive risk factor modification significantly improves outcomes for patients with diabetes and cardiovascular disease (CVD). However, the degree to which secondary prevention treatment targets are achieved in international clinical practice is unknown. Methods: Attainment of 5 secondary prevention targets—aspirin use, lipid control (low-density lipoprotein cholesterol (LDL-C) <70 mg/dL or statin therapy), blood pressure control (<140 mmHg systolic, <90 mmHg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and non-smoking status—was evaluated among 14,671 patients from 38 countries with diabetes and known CVD at entry into TECOS. Logistic regression was used to evaluate the association between individual and regional factors and target achievement. Results: Overall, 29.9% of patients with diabetes and CVD had all 5 secondary prevention measures at target. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of approximately 25%. The likelihood of having individual prevention components at target also varied by region: compared with North America, individuals in all other regions were less likely to have blood pressure at goal, and individuals in Eastern Europe and Latin America were less likely to have LDL-C at target or to be on statin therapy (see Figure). Overall, blood pressure control (57.9%) had the lowest overall attainment while non-smoking status had the highest (89%). Conclusions: On a global scale, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes and CVD, which in turn could lead to reduced risk of downstream cardiovascular events.

scholarly journals Platelet Effects of Anti-diabetic Therapies: New Perspectives in the Management of Patients with Diabetes and Cardiovascular Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Annunziata Nusca ◽  
Dario Tuccinardi ◽  
Silvia Pieralice ◽  
Sara Giannone ◽  
Myriam Carpenito ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Large Population ◽  
Optimal Management ◽  
Direct And Indirect Effects ◽  
Thrombotic Risk ◽  
Glucose Lowering ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes

In type 2 diabetes, anti-thrombotic management is challenging, and current anti-platelet agents have demonstrated reduced efficacy. Old and new anti-diabetic drugs exhibited—besides lowering blood glucose levels—direct and indirect effects on platelet function and on thrombotic milieu, eventually conditioning cardiovascular outcomes. The present review summarizes existing evidence on the effects of glucose-lowering agents on platelet properties, addressing pre-clinical and clinical research, as well as drug–drug interactions with anti-platelet agents. We aimed at expanding clinicians’ understanding by highlighting new opportunities for an optimal management of patients with diabetes and cardiovascular disease. We suggest how an improvement of the thrombotic risk in this large population of patients may be achieved by a careful and tailored combination of anti-diabetic and anti-platelet therapies.

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