Cardiovascular risk management in type 2 diabetes mellitus: A joint position paper of the Italian Cardiology (SIC) and Italian Diabetes (SID) Societies

Using Multiple Statistical Methods to Derive Dietary Patterns Associated with Cardiovascular Disease in Patients with Type 2 Diabetes: Results from a Multiethnic Population-Based Study

“…First, the health effects of dietary patterns are a combination of multiple foods rather than simply adding up the effects of different food groups. Second, the low correlations between the PCA-prudent pattern and blood lipids (TG, HDL-C, and LDL-C) may partially explain these insignificant correlations, as existing evidence suggests that abnormal lipid metabolism in diabetic populations is the cause of CVD [ 42 ]. Third, dietary patterns obtained by PCA tended to reflect the actual eating habits of the target population but maybe weakly correlated with health outcomes because behaviorally relevant patterns do not necessarily predict target disease risk [ 43 ].…”

Implications of the heterogeneity between guideline recommendations for the use of low dose aspirin in primary prevention of cardiovascular disease

“…Noting that asymptomatic patients with DM can have a significant atherosclerotic burden, the ESC/EASD guidelines include a class IIb recommendation for CAC scoring by CT in such patients with at least moderate risk [47] . A joint position paper of the Italian Cardiology (SIC) and Italian Diabetes (SID) Societies on CV risk management in T2DM does not make any specific recommendation for or against the use of low dose aspirin in primary prevention [57] . The most recent Chinese T2DM guideline recommends that aspirin can be used for primary prevention in T2DM patients aged ≥50 years without high bleeding risk and with at least one of the following risk factors: family history of premature ASCVD, hypertension, dyslipidemia, smoking, or CKD/proteinuria [58] .…”

“…10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes – 2020 [55] Aspirin therapy (75–162 mg/day) may be considered as a primary prevention strategy in those with diabetes who are at increased CV risk, after a comprehensive discussion with the patient on the benefits versus the comparable increased risk of bleeding A 2016 European guidelines on CVD prevention in clinical practice [29] Antiplatelet therapy is not recommended for people with DM who do not have CVD III A 107 2021 ESC guidelines on cardiovascular disease prevention in clinical practice [8] In patients with DM at high or very high CVD risk, low dose aspirin may be considered for primary prevention in the absence of clear contraindications IIb A 3, 43, 108 2020 Società Italiane di Cardiologica e Società Italiane di Diabetologia joint document [57] Antiplatelet therapy is not recommended for people with DM who do not have CVD In diabetic patients with multiple risk factors for ASCVD, aspirin use in primary prevention must be evaluated on an individual basis after accurate clinical judgment I I B C 1, 43, 105, 109–115 Guideline for prevention and treatment of type 2 diabetes in China (2020 edition) [58] Aspirin therapy as a primary prevention strategy can be recommended in diabetic patients with high CVD risk; that is, those aged ≥50 years with at least one additional major risk factor (family history of premature ASCVD, hypertension, dyslipidemia, smoking, or CKD/albuminuria) without high bleeding risk IIb Not provided 3, 4, 5, 11, 43, 52, 58, 86, 116 2019 Clinical practice guidelines for type 2 diabetes mellitus in Korea [ 66 ] Aspirin (100 mg daily) may be considered for primary prevention in patients with DM at high CV risk, if they do not have high bleeding risk IIb C 52 ASCVD, atherosclerotic cardiovascular disease; CKD, chronic kidney disease; CV, cardiovascular; CVD, cardiovascular disease; DAPT, dual antiplatelet therapy; DM, diabetes mellitus; GI, gastrointestinal; PPI, proton pump inhibitor. …”

Elevated alanine aminotransferase is associated with biphasic insulin secretion in the healthy elderly Han Chinese population

“… 2 Among the population of elderly people, it increases the risk for atherosclerotic cardiovascular disease, the leading cause of morbidity and mortality in T2DM. 3 Thus, to understand the underlying pathophysiology of T2DM is of major concern to healthcare providers and governments.…”