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Type 1 diabetes and cardiovascular disease

Highlights

Heart and stethoscope

18-07-2019 | Heart failure | Highlight | News

Diabetes-associated heart failure risk greatest in women

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.

Testing blood pressure (symbolic image with models)

25-06-2019 | Hypertension | ADA 2019 | News

Stricter BP thresholds may be needed in type 1 diabetes

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.

Alarm clock and bed

14-12-2018 | Risk factors | Feature | Article

Sleep duration: Waking up to a major metabolic risk factor

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.

Pills

26-08-2018 | Cardiovascular outcomes | Highlight | News

ASCEND results question the use of aspirin, omega-3 supplements in diabetes patients

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.

Child with diabetes (symbolic image with model)

10-08-2018 | Cardiovascular outcomes | Highlight | News

Earlier onset of type 1 diabetes associated with increased risk for adverse outcomes

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.

Increasing trend

07-06-2018 | Cardiovascular disorders | Highlight | News

20 years’ type 1 diabetes duration marks upshift in CVD risk

Type 1 diabetes duration of at least 20 years is linked to increased cardiovascular disease risk, with an increasing association seen after this time, Australian study results suggest.

Testing blood pressure (symbolic image with models)

31-05-2018 | Hypertension | Highlight | News

Masked hypertension common in type 1 diabetes patients

Ambulatory blood pressure monitoring should be used in patients with type 1 diabetes, say researchers who found that almost a quarter had masked hypertension.

UK nutrition guidelines: A fresh approach

22-05-2018 | Nutritional management | Editorial | Article

UK nutrition guidelines for the prevention and management of diabetes: An update for primary care

Advisory Board member Pamela Dyson underlines the key features for healthcare professionals working in diabetes education, diabetes management, type 2 diabetes prevention, and cardiovascular risk reduction.

New Content Item

10-05-2018 | Specific populations | Highlight | News

Women bear brunt of diabetes effect on atherosclerosis mortality

An individual patient data meta-analysis confirms that diabetes increases the likelihood for people dying of atherosclerotic disease, with women the worst affected.

Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).



Learning points include:

  • The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
  • The importance of incorporating understanding of key comorbidities into treatment planning, including:
    • Left ventricular and/or diastolic dysfunction
    • Chronic kidney disease 
    • Benign prostatic hyperplasia
    • Heart failure
  • Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
  • The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
  • Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
  • Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
  • Best practice for avoiding adverse drug events in the acute setting.
  • The challenges associated with treating concomitant heart failure in older adults.

« Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure

Editorial Board member Jay Shubrook talks to treatment individualization specialist David Strain about the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:40).


Learning points include:

  • The ways in which older adults are physiologically distinct from other populations and considerations for appropriate care based on anticipated lifestyle.
  • Expectations for systolic and diastolic blood pressure changes in older adults as well as the impacts they have on cardiovascular health.
  • The importance of specific measures including: pulse pressure, arterial compliance.
  • Risk factors associated with low diastolic blood pressure (<75mmHg) and prospective antihypertensive treatment strategies that may mitigate such risks.

 

« Video 3: When to intervene in patients with diabetes and high blood pressure?



Video 5: Diabetes and blood pressure in the elderly: Which medications to use when; tips for achieving target »

 

Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton get together once more to discuss best practice tips for identifying and treating hypertension in patients with pre-existing diabetes (12:17).



Learning points include:

  • Strategies to avoid common pitfalls when performing blood pressure measurements.
  • The importance of the blood pressure measurements in determining the risk of cardiovascular events.
  • The benefits of dual-action and preload-targeted therapies in hypertensive patients.
  • Why potassium levels are an important factor to consider before initiating treatment.

« Video 2: Why aren't we reaching blood pressure goals, despite the raised target?



Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure »

In the wake of the revised blood pressure targets, recommended by the American Diabetes Association's 2017 Position Statement and 2018 Standards of Care, Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton discuss clinical approaches to get hypertensive diabetes patients to target more consistently (12:29).


Learning points include:

  • The atherogenic risk posed by diabetes and why blood pressure measurements from the arm-alone may not be sufficient to evaluate the threat in all patients.
  • The benefits and drawbacks of the medication classes indicated for hypertension treatment, such as:
    • Diuretics
    • β-blockers
    • Calcium channel blockers
  • The impact and rationale for targeting blood pressures lower than those indicated in the ADA position statement. 

« Video 2: What are the current recommendations for managing high blood pressure in diabetes patients?



Video 3: When to intervene in patients with diabetes and high blood pressure? »

Lori Berard / International Diabetes Federation

13-11-2017 | Specific populations | Interview | Article

Women and diabetes - our right to a healthy future

Editorial Board member Lori Berard addresses 2017's World Diabetes Day theme, providing her insights on the key considerations for managing diabetes in women (9:51).

Hypoglycemia

02-11-2017 | Hypoglycemia | Practical approach | Article

Practical approaches to diagnosing, treating, and preventing hypoglycemia in diabetes

Using a patient-centered care approach, the authors detail how to work in partnership with a patient to prevent hypoglycemia through evidence-based management of the disease and appropriate education.

Counting on hands (one to five)

22-08-2017 | Primary care | View from the clinic | Article

Five things you can do to make your diabetes visits more efficient

Diabetes check-ups can be multifaceted and time-consuming. Editorial Board member and Family Physician, Jay Shubrook, presents his practical recommendations for making the most of your patient visits.