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The American Heart Association and the American Diabetes Association, along with industry leaders, are working together on the groundbreaking initiative — Know Diabetes by Heart — to reduce cardiovascular deaths, heart attacks, heart failure, and strokes in people living with type 2 diabetes (T2D).
Adults with diabetes are twice as likely to experience a heart attack or stroke compared to those without diabetes. Your patients with diabetes need an extra eye on their heart health, and there are resources to support them (and YOU) along the way!
Resources to support diabetes patient care
Know Diabetes by Heart includes a treasure trove of resources and materials to help you prevent and treat cardiovascular disease (CVD) in your patients with diabetes.
- Webinars: Watch this educational series focused on the link between T2D and CVD.
- Podcasts: Listen to this professional education series discussing cutting-edge research, the Standards of Care in Diabetes, shared decision-making, and more.
- Quality Improvement: Learn how hospitals and outpatient clinics can better manage care provided to people with T2D and CVD.
- Standards of Care: Stay current on the latest guidelines and research on T2D and CVD.
- Cardiovascular Disease in Type 2 Diabetes for Health Care Professionals course: This free online, professional education course provides up-to-date knowledge on treating CVD and chronic kidney disease (CKD) in people living with type 2 diabetes.
Screening recommendations in type 2 diabetes patient care
Routine screening is a critical part of identifying and treating any increasing or established heart health concerns. Keep in mind the ABCs of screening:
- A1c: Hemoglobin A1c paints a valuable picture of a patient’s overall blood glucose levels and their risk of developing complications — including CVD. A1cs above 7% are an indication of a patient’s need for further support in a variety of potential areas: lifestyle habits, current medication regimen, new medication opportunities, etc. While many patients may only need A1c tests twice per year, those above their targets could likely benefit from more frequent testing.
- Blood pressure: The silent threat of high blood pressure is only identified with routine testing. Any readings above 120/80 indicate a need for discussion, lifestyle interventions, and potential medication.
- Cholesterol: Monitoring and managing cholesterol levels is an important part of diabetes health. General targets include LDL below 100 mg/dL, HDL over 40 mg/dL, and triglyceride levels below 150 mg/dL. Statin therapy is recommended for all people with diabetes (40-75 years) regardless of cholesterol levels.
Other screening needs: chronic kidney disease
The earliest stages of CKD are nearly silent and invisible — but approximately 1 out of every 3 adults with diabetes have kidney disease. The risk of CKD and further complications is also higher in those with CVD.
Screening for CKD includes:
- eGFR: A GFR result below 60 mL/min/1.73m2 may be the result of impaired kidney function and warrants further evaluation.
- UACR: The urine albumin-to-creatinine ratio (UACR) shows whether a person has albumin in their urine. People with a high amount of albumin in their urine are at an increased risk of having chronic kidney disease and progression to kidney failure.
Medications to consider in patients with T2D & CVD
The variety of medication options available for people with T2D means a greater ability to tailor treatment based on a patient’s needs, goals, preferences, and tolerance.
Medications to consider include:
- SGLT-2 inhibitors: This category of medications includes canagliflozin, empagliflozin, and dapagliflozin. They work by excreting excess glucose through the urine. Side effects include increased thirst, increased need to urinate, increased risk of yeast infections (in women), and modest weight loss.
- In addition to improving glucose levels, SGLT-2 inhibitors can protect kidney and heart health.
- GLP-1 agonists: This category of medications includes liraglutide, semaglutide, and dulaglutide. They work by increasing insulin sensitivity, reducing liver glucose production, increasing satiety, and delaying stomach emptying. Side effects include digestive upset and moderate weight loss.
- In addition to improving glucose levels, GLP-1 agonists can protect kidney and heart health.
- Non-steroidal mineralocorticoid receptor antagonists (nsMRAs): This class of medications includes finerenone, which has been proven to reduce the risk of worsening CKD and CVD. Finerenone works by blocking the activity of certain steroids made in the body that can damage the heart and kidneys. Side effects include low blood pressure, high potassium, and low sodium.
Technology to consider in patients with T2D & CVD
Today’s variety of diabetes technology can be immensely helpful for people with T2D.
Technology to consider includes:
- Continuous glucose monitors (CGM): CGMs are easy to apply at home and minimally invasive. CGMs provide real-time hour-by-hour data that cannot be replicated with finger sticks. Even if used only for a week, this technology can guide critical adjustments in medications and lifestyle habits to improve overall glucose levels.
- Insulin pump or patch: Whether a patient is on both basal and bolus insulin or just basal, today’s pump and patch options can meet the needs of T2D. Insulin pumps and patches can increase dosing adherence, reduce the risk of miscalculating a dose, and simplify the overall process of managing diabetes with insulin.
- Smart insulin pens: Smart insulin pens simplify insulin management with the least technology possible. For those who prefer injections, smart pens can calculate dosages based on carbohydrates, track the time a dose was taken, track insulin-on-board in the hours after a dose, and more.
- Heart monitors & fitness watches: The wide range of heart monitor technology available today makes it easy for patients to wear for daily support. Fitness watches that communicate directly with electrode sensors worn on the body can help a patient with CVD keep a much closer eye on their heart health.
Supporting your patients with T2D & CVD
Supporting your patients with T2D and CVD often involves juggling many different medications, lifestyle guidelines, and education for the daily management of these conditions. Keep it simple — encourage your patients to sign-up for the Know Diabetes by Heart newsletter and take advantage of these great resources!
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