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    Home > Active Ingredient News > Endocrine System > The compliance rate is less than 20%!

    The compliance rate is less than 20%!

    • Last Update: 2022-01-26
    • Source: Internet
    • Author: User
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    ▎WuXi AppTec Content Team Editors Cardiovascular disease is one of the leading causes of death and disability in people with diabetes
    .

    Although great progress has been made in the treatment of diabetes, the incidence of cardiovascular disease in diabetic patients remains high and has become a serious and prominent problem
    .

    At present, how to optimize clinical treatment strategies to improve the prognosis of cardiovascular events in diabetic patients has become one of the primary tasks of diabetes treatment
    .

    On January 10, 2022, the American Heart Association (AHA) issued a heavy scientific statement in Circulation, a well-known journal in the cardiovascular field, calling for attention to the comprehensive management of cardiovascular risk factors for type 2 diabetes
    .

    The contents of the statement mainly include: (1) Evidence and efficacy of new hypoglycemic drugs in improving blood sugar control and reducing cardiovascular events in diabetes; (2) The effect of blood pressure control on cardiovascular events in diabetes; (3) New lipid-lowering therapy on diabetes The role of comprehensive management of cardiovascular risk factors
    .

    In addition, the statement highlights the important role of life>
    .

    Screenshot source: The compliance rate of Circulation is less than 20%.
    Pay attention to the "heart" problem of diabetes! Cardiovascular diseases include coronary heart disease, cerebrovascular disease, heart failure, peripheral arterial disease, congenital heart disease,
    etc.

    Patients with type 2 diabetes often have multiple risk factors for atherosclerosis and cardiovascular disease, such as hypertension, insulin resistance, hyperglycemia, obesity, and dyslipidemia
    .

    Deposition of lipoproteins in arterial walls can lead to atherosclerosis, acute coronary syndromes and cerebrovascular syndromes that occur when plaques deposited in the arterial walls become unstable and rupture; insulin resistance can cause atherosclerosis by promoting Plaque, diastolic dysfunction, and ventricular hypertrophy lead to abnormal large blood vessels; hyperglycemia can promote the occurrence of cardiovascular disease through factors such as glycation end products and oxidative stress
    .

    In addition, insulin resistance and hyperglycemia both contribute to coronary artery disease, cerebrovascular disease, and heart failure
    .

    Professor Joshua J.
    Joseph, chair of the statement writing group and The Ohio State University School of Medicine, stressed that in the United States, fewer than 20% of adults with type 2 diabetes meet their heart disease risk reduction goals (non-smoking; blood sugar, blood pressure, and cholesterol levels) normal)
    .

    The current scientific statement focuses on major adverse cardiovascular events (MACE), including coronary artery disease, cerebrovascular disease, and heart failure, and it is worth noting that adults with type 2 diabetes are twice as likely to die from MACEs as the average adult ! Following an extensive review of evidence from clinical trials up to June 2020, panel members updated the latest evidence on clinical characteristics and better reduction of cardiovascular disease risk in people with type 2 diabetes
    .

    The statement pointed out that the goal of reducing the risk of cardiovascular disease in people with type 2 diabetes should include the following seven areas: Manage blood sugar, blood pressure and cholesterol levels Increase physical activity Improve nutritional fitness levels , higher adherence to a healthy life>
    .

    The latest evidence to help optimize the "lowering blood sugar + protecting the heart" strategy The statement also cites the latest evidence in the treatment of type 2 diabetes, which will help clinicians and patients to transform their treatment strategies, that is, how to better achieve type 2 diabetes management while reducing cardiovascular disease risk factors
    .

    A new approach to blood sugar control The latest AHA statement on blood sugar control was published in 2015, when researchers initially demonstrated that blood sugar-lowering drugs may reduce the risk of heart disease, stroke, heart failure or cardiovascular death
    .

    Since 2015, large-scale clinical trials of these hypoglycemic drugs have been completed, and the results have confirmed that the new type 2 diabetes treatment drug GLP-1 receptor agonists can not only improve blood sugar levels and body weight in patients, but also innovatively reduce heart disease, Risk of stroke, heart failure, and kidney disease
    .

    GLP-1 receptor agonists, such as liraglutide and semaglutide, stimulate insulin release to control blood sugar, and can also lead to weight loss by reducing appetite
    .

    ▲ Potential effects of GLP-1 receptor agonists on cardiovascular disease risk factors (Image source: Reference [1]) In addition, SGLT-2 inhibitors (oral drugs such as canagliflozin, dapagliflozin, etal Glipizin and empagliflozin) can effectively reduce the risk of cardiovascular disease and chronic kidney disease
    .

    SGLT-2 inhibitors reduce the risk of heart failure and, more commonly, renal impairment associated with type 2 diabetes, by stimulating the kidneys to promote glucose excretion from the urine
    .

    ▲ Risk factors potentially targeted by SGLT-2 inhibitors (Image source: Reference [1]) The statement on individualized blood pressure control emphasizes that the principle of individualized treatment should be emphasized in the treatment of hypertension
    .

    Based on this, the management of hypertension should minimize treatment-related side effects and avoid overtreatment of frail patients
    .

    ▲ Different guidelines for blood pressure control recommendations (Image source: Reference [1]) Importance of lowering cholesterol levels AHA pointed out in its recommendations that statins are still the first-line drug of choice in lipid-lowering therapy
    .

    Other types of lipid-lowering drugs, such as ezetimibe, fibrates, and PCSK-9 inhibitors, may be considered for patients who cannot tolerate statins or who cannot achieve their LDL-C goals with statins etc.

    _
    The use of aspirin faces questions in older adults with type 2 diabetes (65 years and older) more likely than the general population to take low-dose daily aspirin to prevent cardiovascular disease
    .

    However, the appropriateness of daily low-dose aspirin therapy is currently being questioned
    .

    The statement pointed out that the latest research published recently showed that aspirin can increase the risk of major bleeding in elderly patients, the treatment risks may outweigh the benefits of treatment
    .

    For some patients, other new, potent antiplatelet drugs may be more effective
    .

    Summary Overall, the latest AHA scientific statement underscores the importance of an integrated, multidisciplinary, and individualized approach in reducing the risk of cardiovascular disease in people with type 2 diabetes, and solemnly calls for urgent action by the medical community, based on the latest evidence-based evidence.
    Best clinical practice to reduce the risk of cardiovascular disease while improving type 2 diabetes treatment and care
    .

    The statement emphasizes that the optimal treatment for patients with type 2 diabetes should include drug or surgical treatment, healthy life>
    .

    Related reading "The Lancet" sub-issue in-depth: Diabetes "sugar control concept" to change! 3 major indicators, 2 new technologies, and 4 new treatments are worth paying attention to.
    JAMA's latest: Over 50% of Chinese adults have diabetes or are in the pre-disease stage! This "three lows" phenomenon is worrying! Weight loss + hypoglycemic "two-pronged approach", will the next breakthrough direction of diabetes treatment be "it"? | "Nature" annual review "Lancet" sub-issue: Dapagliflozin reduces new-onset diabetes by 33%, and two key studies add evidence of benefit! ADA's latest diabetes guidelines: It is recommended that everyone start screening at the age of 35, and metformin may not be the "first choice".
    .
    .
    Source: 123RF reference [1] Joseph JJ, et al.
    , (2022).
    Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: A scientific statement from the American Heart Association.
    Circulation, DOI: 10.
    1161/CIR.
    0000000000001040.
    Disclaimer: WuXi AppTec content team focuses on introducing global biomedical health research progress
    .

    This article is for information exchange purposes only, and the views expressed in this article do not represent WuXi AppTec's position, nor do they represent WuXi AppTec's support or opposition to the views expressed in this article
    .

    This article is also not a treatment plan recommendation
    .

    For guidance on treatment options, please visit a regular hospital
    .

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