Blood glucose control in a diabetic patient with glucometer. – SIMPSON33 / ISTOCK – ARCHIVE
MADRID, 3 Dec. (EUROPA PRESS) –
Up to 40 percent of hospitalizations of people with diabetes in Internal Medicine come from cardiovascular disease, either from heart failure, in 20 percent of cases, or from stroke, ischemic heart disease or peripheral arterial disease; as warned by the first vice president of the Spanish Society of Internal Medicine (SEMI), Dr. Juana Carretero.
This was the opinion of the expert during his speech at the round table “Cardiometabolic risk: where does it start and where does it end?”, Which took place at the 41st SEMI Virtual Congress, in collaboration with Novo Nordisk and participation of experts in the field.
In this sense, insulin resistance “is one of the main determinants of cardiometabolic risk, along with low inflammation, high blood pressure or altered levels of blood lipids (dyslipidemia),” said the doctor of the Internal Medicine Service of the Clinical Hospital University of Valencia, Professor Josep Redon. “All of these are factors that promote the development of cardiovascular disease, kidney disease and type 2 diabetes,” he added.
Therefore, type 2 diabetes is linked to cardiometabolic syndrome, so there is no single mechanism by which sugar increases the risk of suffering a cardiovascular event. In general, they are people with abdominal obesity, based on an inherited genetic risk that, if they also have bad lifestyle habits, tend to develop, in addition to diabetes, hypertension and dyslipidemia. All this affects the blood vessels, favoring the appearance of atheroma plaque, which makes the blood flow become less fluid and the vessels can become clogged.
Thus, circumstances are forming which, as Dr. Carretero points out, mean that “more than half of the complications associated with diabetes are due to cardiovascular disease, and these result in hospitalizations, loss of life expectancy or mortality.”
EARLY AND ACCURATE CONTROL
Experts agreed that it is “essential” to act accurately from the beginning, when there are risk factors for the occurrence of this cardiometabolic syndrome, such as diabetes. In this regard, Dr. Carretero insisted on the need to move to precision medicine in the treatment of type 2 diabetes. “We take a comprehensive approach to the patient and know that there are multiple intermediate metabolic conditions that make a person develop this type of diabetes, therefore, we must try to combine these conditions with genetic modifications to give them the best possible treatment. “
Dr. Redon also recalled that “epigenetic changes already occur in fetal life that establish a whole series of changes to be combined with other elements of daily life, such as diet or physical activity.” He added that “all this favors excess weight, obesity and, consequently, the development of cardiometabolic risk. Therefore, this risk may already be present from childhood and it is “essential” to control and treat it properly.
BENEFITS OF CARDIOMETABLE TREATMENTS
When it comes to treatment, Dr. Carretero drew attention to the availability of very good cardiometabolic treatment options. And, as María Dolores López, a doctor in the Internal Medicine Service of the Regional University Hospital of Malaga, points out, “micro and macro vascular risk is one of the pillars of the morbidity and mortality of people with diabetes in the medium and long term. For this reason, if you have medications such as glucagon type 1 peptide analogues, such as semaglutide, which significantly reduces blood sugar levels while helping to control weight and decreases the risk of a serious cardiovascular event, it is vital for these patients. “