Diabetes News

2013 has seen the publication of two meta-analyses which examine the link between sulphonylurea use and cardiovascular outcomes. They reported an increase in both cardiovascular and all-cause mortality with sulphonylurea therapy. So what are clinicians meant to make of these data?

The diabetes medication vildagliptin may be beneficial in patients with type 2 diabetes and heart failure, but its cardiovascular safety is uncertain, a placebo-controlled trial showed (Medpage)

In older patients with myocardial infarction, we found intensive-dose statin therapy to be effective in reducing repeat hospitalization for acute coronary syndrome. The rate of new-onset diabetes mellitus at long term was not significantly different between intensive-dose and moderate-dose statins (Circulation: Cardiovascular Quality and Outcomes)

In people with type 2 diabetes, a coronary artery calcium score of 10 or greater predicts all cause mortality or cardiovascular events, or both, and cardiovascular events alone, with high sensitivity but low specificity (BMJ)

Here, we review both basic and clinical studies on diabetic cardiomyopathy and summarize problems remaining to be solved for improving management of this type of cardiomyopathy (Heart Failure Reviews)

Whilst the interplay between type 2 diabetes and cardiovascular disease (CVD) has been recognised for many years, recent analyses of existing studies have helped refine several aspects of this relationship with relevance to clinical practice (Diabetologia)

Among patients with diabetes and chronic angina despite treatment with up to 2 agents, ranolazine reduced angina and sublingual nitroglycerin use and was well tolerated (Journal of the American College of Cardiology)

Our results lend support to the recent American Diabetes Association/ European Association for the Study of Diabetes position statement that emphasizes the importance of additional factors, including the propensity for hypoglycaemia, which should influence HbA1c targets and treatment choices for individual patients (Diabetic Medicine)

Improved glycemic control based on glycated albumin (GA) and plasma glucose predicted CV-related hospitalizations; GA also predicted CV hospitalization length of stay. HbA1c did not predict cause-specific hospitalizations in dialysis populations (American Journal of Nephrology)

PWV was higher among patients with well-controlled type 2 diabetes compared with controls and was independently associated with WMLs. PWV may represent a clinically relevant parameter in the evaluation of cerebrovascular disease risk in type 2 diabetes (Diabetes Care)

Serum GA level is a better indicator than HbA1c for evaluating the presence and severity of CAD and predicting major adverse cardiac events in patients with T2DM (Cardiology)

An early invasive strategy yielded similar RR reductions in overall cardiovascular events in diabetic and nondiabetic patients. However, an invasive strategy appeared to reduce recurrent nonfatal MI to a greater extent in diabetic patients. These data support the updated guidelines that recommend an invasive strategy for patients with diabetes mellitus and non–ST-segment elevation acute coronary syndromes (Journal of the American College of Cardiology)

This review calls attention to the lack in knowledge, understanding, and general awareness of medical and scientific societies on how to treat and prevent diabetic vascular disease in women. Despite the evident gender-associated differences in the phathophysiology of CVD and the higher incidence of vascular disease in diabetic women, the trends and guidelines are dominated by data obtained in men (Experimental Diabetes Research)

Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality; the strength of the association is most consistent for diabetes (Diabetologia)

An analysis from the JUPITER trial (Lancet)

An early invasive strategy yielded similar RR reductions in overall cardiovascular events in diabetic and nondiabetic patients. However, an invasive strategy appeared to reduce recurrent nonfatal MI to a greater extent in diabetic patients (Journal of the American College of Cardiology)

Our data suggest that there is an association between good glycaemic control to obtain HbA1c levels (both pre-procedural glycaemic control and post-procedural) with a better clinical outcome after PCI (Cardiovascular Diabetology)

Older adults who have diabetes, cardiovascular disease, and 6 or more comorbid conditions may represent a subgroup of older adults who are less likely to benefit from intensive glycemic control (Centers for Disease Control and Prevention)

Patients with DM and MetS displayed significant changes in QRS complex that suggest depolarization sequence deterioration (Journal of Electrocardiology)