Diabetes complications and comorbidities: Cardiovascular disease

Diabetes is a stronger risk factor for heart failure among women compared with men, indicate the results of a large systematic review and meta-analysis.

Findings from an observational cohort study suggest that a blood pressure target of 120/80 mmHg may be needed for effective prevention of coronary artery disease in people with type 1 diabetes.

Detailed analysis of renal outcomes in the DECLARE-TIMI 58 trial confirms that treatment with the sodium-glucose cotransporter 2 inhibitor dapagliflozin is renoprotective in patients with type 2 diabetes and preserved kidney function.

Escalating obesity prevalence and severity has led to type 2 diabetes being diagnosed in ever-younger people, including children. medwireNews rounds up the accumulating evidence suggesting a particularly severe diabetes course in these young people.

The association between poor glycemic control during pregnancy and subsequent risk for cardiovascular disease extends to women without gestational diabetes, study findings suggest.

Further analysis of the DECLARE-TIMI 58 trial shows dapagliflozin to be of particular benefit for patients who have previous myocardial infarction or heart failure with reduced ejection fraction.

The incidence of coronary heart disease has declined in recent years but people with type 2 diabetes continue to have a significantly greater risk than those without, Scottish data show.

The effect of sleep duration on glucose regulation and cardiometabolic risk is becoming an increasingly high-profile issue. medwireNews takes a look at the latest evidence, which shows the gravity of the problem but also offers some solutions.

The LEADER investigators report that treatment with the glucagon-like peptide-1 receptor agonist liraglutide may be of particular benefit in the oldest patients with type 2 diabetes.

The results of the DECLARE-TIMI 58 trial show a broadly positive effect of dapagliflozin on cardiovascular outcomes, especially heart failure, in patients with type 2 diabetes.

Type 2 diabetes and polyvascular disease are additive risk factors for cardiovascular events in patients with acute coronary syndromes, a secondary analysis of the IMPROVE-IT trial suggests.

An observational study published in JAMA demonstrates a substantial reduction in the risk for hard cardiovascular endpoints in obese patients with type 2 diabetes who have undergone bariatric surgery.

Results of the Harmony Outcomes trial indicate that adding the glucagon-like peptide-1 receptor agonist albiglutide to standard care may reduce cardiovascular risk among patients with type 2 diabetes and existing cardiovascular disease.

Findings from a phase IV trial suggest that aspirin use may reduce the risk for primary vascular events but at the cost of increased major bleeding risk in patients with diabetes, while omega-3 fatty acid supplementation does not have a cardioprotective effect.

The weight-loss medication lorcaserin neither increases nor reduces cardiovascular risk, report the CAMELLIA–TIMI 61 investigators.

A study of the Swedish National Diabetes Register suggests that keeping five cardiovascular risk factor variables within the target ranges could offset the excess risk for death, myocardial infarction, or stroke among patients with type 2 diabetes relative to the general population.

Patients with type 1 diabetes diagnosed before the age of 10 years have a higher risk for cardiovascular complications and a shorter life expectancy than those who develop the disease at an older age, study results published in The Lancet suggest.

Research shows that starting second-line sulfonylurea treatment is associated with an increased risk for cardiovascular and hypoglycemic events among patients with type 2 diabetes in clinical practice, although the risk is less if they continue using metformin rather than switching completely.

Dawwas GK, Smith SM, Park H. Cardiovasc Diabetol 2018; 17: 102. doi: 10.1186/s12933-018-0746-4

Harrington JL et al. Curr Diab Rep 2018; 18: 64. doi: 10.1007/s11892-018-1035-z