New approach to diabetes care: from blood glucose to cardiovascular disease

Rev Port Cardiol (Engl Ed). 2019 Jan;38(1):53-63. doi: 10.1016/j.repc.2018.03.013. Epub 2019 Jan 23.
[Article in English, Portuguese]

Abstract

Diabetes, a metabolic disease with vascular consequences due to accelerated atherosclerosis, is one of the 21st century's most prevalent chronic diseases. Characterized by inability to produce or use insulin, leading to hyperglycemia and insulin deficiency, diabetes causes a variety of microvascular (such as retinopathy and kidney disease) and macrovascular complications (including myocardial infarction and stroke) which reduce the quality of life and life expectancy of individuals with diabetes. We describe the close relationship between diabetes, cardiovascular risk factors, and cardiovascular disease, and examine multifactorial approaches to diabetes treatment, including reducing cardiovascular risk in individuals with type 2 diabetes. Finally, we analyze new prospects for the treatment of type 2 diabetes, resulting from the development of novel antidiabetic drugs. The aim of this review is that the clinician should assume the crucial role of guiding individuals with diabetes in the control of their disease, in order to improve their quality of life and prognosis. In view of the currently available evidence, the emergence of new glucose-reducing therapies with proven cardiovascular benefit means that the best therapeutic strategy for diabetes must go beyond reducing hyperglycemia and aim to reduce cardiovascular risk.

Keywords: Agonistas do recetor do peptídeo tipo 1 semelhante ao glucagon; Cardiovascular disease; Diabetes; Diabetes mellitus; Doenças cardiovasculares; Fatores de risco; Glucagon‐like peptide‐1 receptor agonists; Inibidores do cotransportador sódio‐glicose 2; Resultado do tratamento; Risk factors; Sodium‐glucose transporter 2 inhibitors; Treatment outcome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / metabolism*
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / drug therapy*
  • Disease Management*
  • Humans
  • Hypoglycemic Agents / therapeutic use*

Substances

  • Blood Glucose
  • Hypoglycemic Agents