Comprehensive Cardiovascular and Renal Protection in Patients with Type 2 Diabetes

J Clin Med. 2023 Jun 8;12(12):3925. doi: 10.3390/jcm12123925.

Abstract

Type 2 diabetes (T2DM) is one of the main public health care problems worldwide. It is associated with a marked increased risk of developing atherosclerotic vascular disease, heart failure, chronic kidney disease and death. It is essential to act during the early phases of the disease, through the intensification of lifestyle changes and the prescription of those drugs that have been shown to reduce these complications, with the aim not only of achieving an adequate metabolic control, but also a comprehensive vascular risk control. In this consensus document, developed by the different specialists that treat these patients (endocrinologists, primary care physicians, internists, nephrologists and cardiologists), a more appropriate approach in the management of patients with T2DM or its complications is provided. A particular focus is given to the global control of cardiovascular risk factors, the inclusion of weight within the therapeutic objectives, the education of patients, the deprescription of those drugs without cardiovascular benefit, and the inclusion of GLP-1 receptor agonists and SGLT2 inhibitors as cardiovascular protective drugs, at the same level as statins, acetylsalicylic acid, or renin angiotensin system inhibitors.

Keywords: GLP-1 receptor agonists; SGLT2 inhibitors; cardiovascular; diabetes; glycated hemoglobin; renal.

Publication types

  • Review

Grants and funding

This research received no external funding. This study was promoted by the working group of Diabetes and Obesity of the Vascular Risk and Cardiac Rehabilitation Association of the Spanish Society of Cardiology.