Bridging the Gap for Patients with Diabetes and Cardiovascular Disease Through Cardiometabolic Collaboration
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Purpose of Review
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with type 2 diabetes (T2D). Recent cardiovascular outcome trials (CVOTs) have established sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1 RA) as powerful medications that can lower glucose as well as reduce the risk of complications of CVD in many individuals with T2D. The combination of glycemic and cardiovascular benefits of SGLT2i and GLP1 RA has highlighted the importance of collaborative care of patients by diabetes and cardiovascular specialists. We review several models of cardiometabolic care for patients with diabetes and CVD and discuss practical ways in which diabetes and cardiovascular specialists can work together to improve cardiometabolic care.
CVOTs for SGLT2i and GLP1 RA have demonstrated a significant reduction in major adverse cardiovascular events in individuals with T2D and CVD, in addition to their beneficial effects on glucose lowering and weight loss. Additionally, several models of care, including population health screening models with or without a remote management intervention, multidisciplinary clinics, and combined cardiometabolic training, have been proposed to better facilitate the multifaceted care that individuals with diabetes and CVD require.
Innovative models of cardiometabolic care have the potential to improve the quality of care that individuals with diabetes and CVD receive. Through collaboration and co-management, diabetes specialists, cardiovascular specialists, and primary care providers have the ability to optimize diabetes and cardiovascular care.
KeywordsType 2 diabetes Cardiometabolic SGLT2 inhibitors GLP1 receptor agonists Cardiovascular outcome trials
Compliance with Ethical Standards
Conflict of Interest
Lee-Shing Chang reports grants from Boehringer Ingelheim, Sanofi, and Novo Nordisk.
Muthiah Vaduganathan receives research support from Harvard Catalyst and serves on advisory boards for Amgen, AstraZeneca, Baxter Healthcare, Bayer AG, and Boehringer Ingelheim.
Jorge Plutzky reports grants from Boehringer Ingelheim; and personal fees from Novo Nordisk, Merck, Janssen, and Amgen.
Vanita R. Aroda reports other from Adocia; personal fees from BD and Zafgen; grants from Calibra, Eisai, Theracos, Elcelyx, and Fractyl; grants and personal fees from AstraZeneca, Novo Nordisk, and Sanofi; and grants and other from Janssen.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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