David Aguilar, MD: New Treatments and New Responsibilites

David Aguilar, MD: So I think that in the last year, 2 diabetes medicines - a medicine called liraglutide, which is a GLP1 agonist, and empagliflozin, which is an SGL-2 inhibitor (and has received a lot of attention at HFSA and other heart meetings) - have both been approved and received an FDA indication for cardiovascular mortality in patients that have type 2 diabetes and are at high risk for heart disease or who have heart disease. That's a really big deal because there are no other diabetes medicines that have that indication, so when cardiologists are sitting in the audience, whether they're heart failure specialists or general cardiologists, we now have treatment options that have been shown to improve mortality.

So it used to be in the realm of an endocrinologist or a general medicine doctor, who would hear that. Now, we have agents used to treat diabetes that have improved mortality in patients that we see. So now there's this new sort of responsibility, a shared responsibility if you will. So I think for me, when we talk to cardiologists, there's really a need to become familiar with these medications and to be aware of this new data as we try, with the ultimate outcome, to improve quality and quantity of our patients' lives.

I think that's what's a little bit different now. I think for the longest time with cardiologists, we were able to kind of put this in the realm of a primary care doctor or an endocrinologist, but with the new amount of data showing benefit not just in diabetes, but in heart disease, there's more responsibility that comes with that. We have to be aware of the data, be aware of the side effects, to form collaborations with internists or endocrinologists or even take responsibility on our own, but you just have to be aware of the medications. If you are aware and if you decide to treat patients, or have patients on these medicines, you definitely have to be aware of the adverse effects. Again, it's something we might have relegated in the past to some of the other doctors, but now for us, it becomes very important.