March 8th 2024
On March 08, 2024, the FDA approved semaglutide 2.4 mg (Wegovy) to reduce cardiovascular risk in adults with obesity or overweight and heart disease based on the SELECT trial.
Traditional risk factors across short-, intermediate-, and long-term follow-up in men and women
February 18th 2009We found sex differences in the pattern of relative strength when riskfactor associations with death from cardiovascular disease (CVD) were evaluated across different periods of follow-up. In women, an increased risk in CVD-related death was associated with diabetes mellitus and smoking; this risk was most prominent in the early follow-up period. Our finding illustrates that clinicians should employ more intense preventive measures in women who are smokers or have diabetes.
DIGAMI 2 trial post hoc analysis: Lessons in overinterpretation
December 17th 2008In their post hoc analysis of the DIGAMI 2 (Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction 2) study, Mellbin and colleagues suggest that insulin therapy after myocardial infarction (MI) may be associated with increased clinical events (not mortality), whereas metformin therapy may be associated with reduced events and sulfonylurea therapy with neutral effects.
Impact of diabetes development on atrial fibrillation in hypertensive patients
Patients with new-onset diabetes mellitus in the VALUE (Valsartan Antihypertensive Long-term Use Evaluation) trial had an increased incidence of atrial fibrillation compared with patients without diabetes. Clustering of risk factors or the presence of dysglycemia may make the heart more susceptible to arrhythmias.
Insulin as a strategy to optimize glycemic control in patients with type 2 diabetes
November 14th 2008Treatment of type 2 diabetes should achieve and maintain euglycemia, thereby preventing complications from this progressive disease. Current antidiabetic therapies should be a part of a multimodal management program that includes diet, exercise, and blood pressure and lipid control. Oral antidiabetic drugs are still first-line therapy for type 2 diabetes, but intensification of therapy, including starting insulin, should occur every 2 to 3 months as needed to achieve euglycemia. The first insulin added is typically a basal insulin, which is effective in lowering fasting plasma glucose (FPG). A persistently elevated glycated hemoglobin (HgbA1C) level despite near or complete normalization of FPG, however, indicates postprandial hyperglycemia. In these cases, the addition of bolus insulin is required to reduce postprandial glucose (PPG). Several approaches to initiate and titrate insulin can be used based on FPG, PPG, HgbA1C, and patient factors.
Glycemic control and CVD outcomes: Randomized clinical trials in 2008
November 14th 2008The relationship of glucose levels to cardiovascular disease (CVD) risk, especially coronary heart disease (CHD), in observational data sets has been the subject of several studies. These studies have shown that the relationship between fasting (and postprandial glucose) and CHD risk is continuous and graded, and that this relationship extends below the currently defined threshold for diagnosing diabetes mellitus. The assumption has been that glycemic control in patients with diabetes mellitus should favorably affect CVD outcomes in randomized clinical trials; however, the results of several large trials have not consistently confirmed this hypothesis. In fact, ACCORD (Action to Control Cardiovascular Risk in Diabetes) data suggest a small increased risk in mortality for patients at high risk for CHD events.