Cardiovascular disease in type 2 diabetes mellitus: progress toward personalized management

Abstract

Cardiovascular diseases (CVDs) are the main cause of death among patients with type 2 diabetes mellitus (T2DM), particularly in low- and middle-income countries. To effectively prevent the development of CVDs in T2DM, considerable effort has been made to explore novel preventive approaches, individualized glycemic control and cardiovascular risk management (strict blood pressure and lipid control), together with recently developed glucose-lowering agents and lipid-lowering drugs. This review mainly addresses the important issues affecting the choice of antidiabetic agents and lipid, blood pressure and antiplatelet treatments considering the cardiovascular status of the patient. Finally, we also discuss the changes in therapy principles underlying CVDs in T2DM.

The worsening effect of anemia on left ventricular function and global strain in type 2 diabetes mellitus patients: a 3.0 T CMR feature tracking study

“…The result of LVEF and LVMI is similar to a previous study [ 20 ]. T2DM leads to cardiac stiffness, myocardial fibrosis and hypertrophy by multiple mechanisms, such as hyperglycemia, systemic and cardiac insulin resistance, calcium disturbance in cardiomyocytes, inflammation, microvascular dysfunction and so on [ 21 , 22 ], which put tremendous stress on the heart independently to other risk factors [ 23 , 24 ]. LV global strain is acquired by tracking the myocardial motions between the epicardial and endocardial borders.…”

Antidiabetic actions of GPR55 agonist Abn-CBD and sitagliptin in obese-diabetic high fat fed mice

“…In addition, Abn-CBD plus sitagliptin ameliorated plasma C-reactive protein concentrations; a biomarker that correlates with cardiovascular disease (CVD) risk and cardiovascular health (Clearfield 2005, Bahadursingh et al 2009. This is a significant finding as there is a pressing need for new therapies that counteract the development of CVD in type 2 diabetes, particularly as CVD is the main cause of death among patients with type 2 diabetes (Ma et al 2022). With ongoing deterioration of glycaemic control and the detrimental impact of diabetic complications, new drug development focused on beta cell and in addition cardiovascular health benefits is needed.…”

Higher systolic blood pressure is specifically associated with better islet beta-cell function in T2DM patients with high glycemic level

“…Short-term elevation in SBP might be a compensatory mechanism in response to hyperglycemia-induced increase in blood viscosity, which aims to ensure sufficient blood supply to vital organs, in this case, the pancreatic islets. We should nevertheless recognize that hypertension is a major risk factor for cardiovascular disease [ 30 ], which is the leading cause of morbidity and mortality for individuals with diabetes [ 31 – 33 ]. Thus, we must highlight that our study does not encourage the maintenance of a sustained state of hypertension in T2DM patients with poor glycemic control.…”