Cardio-renal-metabolic disease in primary care setting

Mahmoud Ibrahim¹, Ebtesam M Ba-Essa², Jason Baker³, Avivit Cahn⁴, Antonio Ceriello⁵, Francesco Cosentino⁶, Melanie J Davies^{7

8}, Robert H Eckel⁹, Luc Van Gaal¹⁰, Peter Gaede¹¹, Yehuda Handelsman¹², Samuel Klein^{13

14}, Richard David Leslie¹⁵, Paolo Pozzilli^{15

16}, Stefano Del Prato¹⁷, Francesco Prattichizzo⁵, Oliver Schnell¹⁸, Petar M Seferovic¹⁹, Eberhard Standl¹⁸, Abraham Thomas²⁰, Jaakko Tuomilehto^{21

22

23}, Paul Valensi²⁴, Guillermo E Umpierrez²⁵

Affiliations

¹ EDC, Centre for Diabetes Education, Charlotte, North Carolina, USA.
² Al-Rawdah General Hospital, Dammam, Saudi Arabia.
³ Weill Cornell Medicine, New York, New York, USA.
⁴ The Diabetes Unit & Endocrinology and Metabolism Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.
⁵ IRCCS MultiMedica, Milan, Italy.
⁶ Unit of Cardiology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
⁷ Diabetes Research Centre, University of Leicester, Leicester, UK.
⁸ NIHR Leicester Biomedical Research Centre, Leicester, UK.
⁹ University of Colorado Anschutz Medical Campus and University of Colorado Hospital, Aurora, Colorado, USA.
¹⁰ Department of Endocrinology, Diabetology, and Metabolism, Antwerp University Hospital, Antwerp, Belgium.
¹¹ Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark.
¹² Metabolic Institute of America, Tarzana, California, USA.
¹³ Washington University School of Medicine, Saint Louis, Missouri, USA.
¹⁴ Sansum Diabetes Research Institute, Santa Barbara, California, USA.
¹⁵ Blizard Institute, Centre of Immunobiology, Barts and the London School of Medicine, Queen Mary, University of London, London, UK.
¹⁶ Campus Bio-Medico University, Rome, Italy.
¹⁷ University of Pisa and Sant'Anna School of Advanced Studies, Pisa, Italy.
¹⁸ Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany.
¹⁹ Serbian Academy of Sciences and Arts, University of Belgrade Faculty of Medicine and Belgrade University Medical Center, Belgrade, Serbia.
²⁰ Thomas Consulting, Weymouth, Connecticut, USA.
²¹ Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
²² Department of Public Health, University of Helsinki, Helsinki, Finland.
²³ Diabetes Research Unit, King Abdulaziz University, Jeddah, Saudi Arabia.
²⁴ Polyclinique d'Aubervilliers, Aubervilliers and Paris Nord University, Bobigny, France.
²⁵ Emory University School of Medicine, Atlanta, Georgia, USA.

PMID: 38115715
PMCID: PMC11320716
DOI: 10.1002/dmrr.3755

Review

Cardio-renal-metabolic disease in primary care setting

Mahmoud Ibrahim et al. Diabetes Metab Res Rev. 2024 Mar.

. 2024 Mar;40(3):e3755.

doi: 10.1002/dmrr.3755. Epub 2023 Dec 19.

Authors

Affiliations

¹ EDC, Centre for Diabetes Education, Charlotte, North Carolina, USA.
² Al-Rawdah General Hospital, Dammam, Saudi Arabia.
³ Weill Cornell Medicine, New York, New York, USA.
⁴ The Diabetes Unit & Endocrinology and Metabolism Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.
⁵ IRCCS MultiMedica, Milan, Italy.
⁶ Unit of Cardiology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
⁷ Diabetes Research Centre, University of Leicester, Leicester, UK.
⁸ NIHR Leicester Biomedical Research Centre, Leicester, UK.
⁹ University of Colorado Anschutz Medical Campus and University of Colorado Hospital, Aurora, Colorado, USA.
¹⁰ Department of Endocrinology, Diabetology, and Metabolism, Antwerp University Hospital, Antwerp, Belgium.
¹¹ Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark.
¹² Metabolic Institute of America, Tarzana, California, USA.
¹³ Washington University School of Medicine, Saint Louis, Missouri, USA.
¹⁴ Sansum Diabetes Research Institute, Santa Barbara, California, USA.
¹⁵ Blizard Institute, Centre of Immunobiology, Barts and the London School of Medicine, Queen Mary, University of London, London, UK.
¹⁶ Campus Bio-Medico University, Rome, Italy.
¹⁷ University of Pisa and Sant'Anna School of Advanced Studies, Pisa, Italy.
¹⁸ Forschergruppe Diabetes eV at the Helmholtz Centre, Munich-Neuherberg, Germany.
¹⁹ Serbian Academy of Sciences and Arts, University of Belgrade Faculty of Medicine and Belgrade University Medical Center, Belgrade, Serbia.
²⁰ Thomas Consulting, Weymouth, Connecticut, USA.
²¹ Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
²² Department of Public Health, University of Helsinki, Helsinki, Finland.
²³ Diabetes Research Unit, King Abdulaziz University, Jeddah, Saudi Arabia.
²⁴ Polyclinique d'Aubervilliers, Aubervilliers and Paris Nord University, Bobigny, France.
²⁵ Emory University School of Medicine, Atlanta, Georgia, USA.

PMID: 38115715
PMCID: PMC11320716
DOI: 10.1002/dmrr.3755

Abstract

In the primary care setting providers have more tools available than ever before to impact positively obesity, diabetes, and their complications, such as renal and cardiac diseases. It is important to recognise what is available for treatment taking into account diabetes heterogeneity. For those who develop type 2 diabetes (T2DM), effective treatments are available that for the first time have shown a benefit in reducing mortality and macrovascular complications, in addition to the well-established benefits of glucose control in reducing microvascular complications. Some of the newer medications for treating hyperglycaemia have also a positive impact in reducing heart failure (HF). Technological advances have also contributed to improving the quality of care in patients with diabetes. The use of technology, such as continuous glucose monitoring systems (CGM), has improved significantly glucose and glycated haemoglobin A1c (HbA1c) values, while limiting the frequency of hypoglycaemia. Other technological support derives from the use of predictive algorithms that need to be refined to help predict those subjects who are at great risk of developing the disease and/or its complications, or who may require care by other specialists. In this review we also provide recommendations for the optimal use of the new medications; sodium-glucose co-transporter-2 inhibitors (SGLT2i) and Glucagon-like peptide-receptor agonists 1 (GLP1RA) in the primary care setting considering the relevance of these drugs for the management of T2DM also in its early stage.

Keywords: CVOTs; chronic kidney disease; heart failure; obesity; technology; type 2 diabetes.

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Figures

**Algorithm 1;. Heart, Type 2-Diabetes, Kidney: physical, technical & biochemical examinations making the link**
* HS; high sensitivity - NT-proBNP; N-terminal pro B-type Natriuretic Peptide - BNP; brain natriuretic peptide - ACR; albumin creatinine ratio - CRP; C reactive protein - OGTT; oral glucose tolerance test - PVD; peripheral vascular disease - CAD; coronary artery disease Standl E & Schnell O; 2023

**Algorithm 2;. Type 2-diabetes and related cardio-renal-metabolic challenges: a diagnostic and management algorithm**
- TIA; transient ischemic attack - HT; hypertension - BB; B-blockers - BP; blood pressure Standl E & Schnell O; 2023

See this image and copyright information in PMC

References

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Cardio-renal-metabolic disease in primary care setting

Affiliations

Cardio-renal-metabolic disease in primary care setting

Authors

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Abstract

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References

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LinkOut - more resources

Full Text Sources

Medical

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