Management of Diabetes in Cardiovascular Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 20 August 2024 | Viewed by 1920

Special Issue Editor


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Guest Editor
Head of Department. Department of Endocrinology and Nutrition, Hospital Universitario Fundacion Alcorcon, Alcorcon, 28922 Madrid, Spain
Interests: type 2 diabetes; obesity; metabolic surgery; precision diabetology
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Special Issue Information

Dear Colleagues,

We cordially invite you to participate as an author in this Special Issue of JCM on “Management of Diabetes in Cardiovascular Diseases”.

Multiple cardiovascular (CV) risk factors, such as hypertension, dyslipidemia, obesity and inflammation, often coexist in individuals with type 2 diabetes (T2DM). Atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) are leading causes of morbidity and mortality for these patients. Intensive glycemic control reduces the microvascular complications of T2DM, but it does not provide a clear beneficial effect on ASCVD or HF. In recent years, several glucose-lowering drugs (GLDs) from two therapeutic families, GLP-1 receptor agonists and sodium-glucose co-transporter type 2 inhibitors, have shown a reduction in CV and renal morbidity and mortality in patients with T2DM and CV disease. A comprehensive approach to CV reduction in T2DM should include these GLDs, irrespective of the glycemic control or metformin use, and at the same level as other drugs with CV or renal protection, such as statins, PCSK-9 inhibitors, bempedoic acid, icosapent ethyl, ezetimibe, acetylsalicylic acid, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers or finerenone. Other important elements of the multifactorial intensification of therapy in patients with T2DM and CV disease include a healthy lifestyle, weight loss in overweight patients, and deprescription of those drugs without CV benefit and, in some cases, metabolic surgery.

In summary, we have multiple tools to change the natural history of patients with T2DM and ASCVD or HF at present. We look forward to receiving your submissions to this Special Issue.

Dr. Juan José Gorgojo-Martínez
Guest Editor

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Keywords

  • type 2 diabetes
  • cardiovascular disease
  • lifestyle
  • SGLT-2 inhibitors
  • GLP-1 receptor agonists
  • weight-loss drugs
  • metabolic surgery.

Published Papers (1 paper)

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Research

14 pages, 815 KiB  
Article
Effectiveness and Tolerability of the Intensification of Canagliflozin Dose from 100 mg to 300 mg Daily in Patients with Type 2 Diabetes in Real Life: The INTENSIFY Study
by Juan J. Gorgojo-Martinez, Pablo José Ferreira-Ocampo, Alba Galdón Sanz-Pastor, Jersy Cárdenas-Salas, Teresa Antón-Bravo, Miguel Brito-Sanfiel and Francisca Almodóvar-Ruiz
J. Clin. Med. 2023, 12(13), 4248; https://doi.org/10.3390/jcm12134248 - 25 Jun 2023
Cited by 2 | Viewed by 1665
Abstract
Aim: This study aimed to evaluate the effectiveness and tolerability of intensifying the dose of canagliflozin from 100 mg/day (CANA100) to 300 mg/day (CANA300) in patients with type 2 diabetes (T2DM) and suboptimal metabolic control in a real-world setting. Methods: A multicenter observational [...] Read more.
Aim: This study aimed to evaluate the effectiveness and tolerability of intensifying the dose of canagliflozin from 100 mg/day (CANA100) to 300 mg/day (CANA300) in patients with type 2 diabetes (T2DM) and suboptimal metabolic control in a real-world setting. Methods: A multicenter observational study was conducted on adult patients with T2DM who initiated treatment with CANA100 and subsequently required intensification to CANA300. The primary outcome measures were changes in HbA1c and weight at 6 months after the switch and at the end of the follow-up period. Results: A total of 317 patients met the inclusion criteria (59.6% male, mean age 62.2 years, baseline HbA1c 7.55%, weight 88.6 kg, median duration of treatment with CANA100 9.9 months). Switching to CANA300 resulted in a significant reduction in HbA1c (6 months: −0.33%; last visit: −0.47%, both p < 0.0001) and weight (6 months: −1.8 kg; last visit: −2.9 kg, both p < 0.0001) over a median follow-up period of 20.8 months. The proportion of patients that achieved HbA1c < 7% increased from 26.7% with CANA100 to 51.6% with CANA300 (p < 0.0001). Among individuals with poor baseline glycemic control (HbA1c > 8%, mean 9.0%), HbA1c was significantly reduced by −1.24% (p < 0.0001). Furthermore, significant improvements were observed in fasting plasma glucose (FPG), blood pressure (BP), liver enzymes, and albuminuria. No unexpected adverse events were reported. Conclusions: Intensifying the treatment to CANA300 in a real-world setting resulted in further significant and clinically relevant reductions in FPG, HbA1c, weight, and BP in patients with T2DM. The switch was particularly effective in patients with higher baseline HbA1c levels. Full article
(This article belongs to the Special Issue Management of Diabetes in Cardiovascular Diseases)
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