When treating your adult patients with T2D, are you considering that patients may be forgetting to mention certain lifestyle factors that may impact your treatment decisions? Their cardiovascular (CV) risk may be greater than you both realize. Below are some modifiable and non-modifiable factors that you may be overlooking when talking to your patients with T2D. As you go through the following questions, and review the patient profiles below, consider whether you see patients in your practice with similar CV risk.
Is your patient taking their prescribed heart medicine?
Does your patient have a family history of CVD?
When it comes to CV risk, sometimes there is more to the story
What do these patient stories have in common with your own?
Hypothetical patient case studies.
Consider how to help lower A1C and reduce CV risk for your patients with T2D and established CVD
- American Heart Association. Lifestyle changes for heart attack prevention. http://www.heart.org/HEARTORG/Conditions/HeartAttack/LifeAfteraHeartAttack/Lifestyle-Changes-for-Heart-Attack-Prevention_UCM_303934_Article.jsp#.WmtgI66nHDc. Accessed September 13, 2018.
- Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: have all risk factors the same strength? World J Diabetes. 2014;5(4):444-470.
- American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;41(suppl 1):S1-S172.
- Centers for Disease Control and Prevention. Losing Weight. https://www.cdc.gov/healthyweight/losing_weight/index.html. Accessed August 27, 2018.
- Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67-e492.
- American Heart Association. Understand Your Risks to Prevent a Heart Attack. https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack. Accessed August 26, 2018.
- van der Heijden AAWA, Van’t Riet E, Bot SDM, et al. Risk of a recurrent cardiovascular event in individuals with type 2 diabetes or intermediate hyperglycemia. Diabetes Care. 2013;36:3498-3502.
- U.S. Department of Health and Human Services. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease. A report of the surgeon general. Rockville, MD: Dept. of Health and Human Services, Public Health Service, Office of Surgeon General. 2010:1-706.
- American Heart Association. Smoking & cardiovascular disease (heart disease). http://www.heart.org/HEARTORG/HealthyLiving/QuitSmoking/QuittingResources/Smoking-Cardiovascular-Disease-Heart-Disease_UCM_305187_Article.jsp#.W5lExZNKj-Y. Accessed September 12, 2018.
- Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Clinical update: cardiovascular disease in diabetes mellitus. Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus-mechanisms, management, and clinical considerations. Circulation. 2016;133:2459-2502.
- Fox CS, Sullivan L, D’Agostino RB Sr, Wilson PWF; the Framingham Heart Study. The significant effect of diabetes duration on coronary heart disease mortality. Diabetes Care. 2004;27(3):704-708.
- Halter JB, Musi N, McFarland Horne F, et al. Diabetes and cardiovascular disease in older adults: current status and future directions. Diabetes. 2014;63:2578-2589.
- Gerstein HC, Miller ME, Genuth S, et al; ACCORD Study Group. Long-term effects on intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011;364:8181-828.
- Stolar M. Glycemic control and complications in type 2 diabetes mellitus. Am J Med. 2010;123: S3-S11.