Preventing Heart Disease in People With Diabetes

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It’s well known that having diabetes unfortunately puts a person at a greater risk of heart trouble. The problem has been that physicians with diabetes patients tend to concentrate primarily, if not solely, on blood sugar control. This can leave those patients at risk of heart attack or stroke. But that might change, based on a new study published in the Journal of General Internal Medicine.

The authors of the study reviewed the results of four clinical trials published in The New England Journal of Medicine over the past two years. The trials specifically studied people who had diabetes or who were at risk of diabetes and who had suffered a heart attack or a stroke. The researchers tested four blood sugar-lowering medications on these patients. These were pioglitazone (brand name Actos), empagliflozin (Jardiance), liraglutide (Victoza), or semaglutide (Ozempic). What the researchers wanted to find out was whether these relatively newer drugs were safe for people with diabetes who had experienced heart trouble. What they found surprised them. Not only were the medications safe, but also the patients experienced cardiovascular improvements. The reason this was surprising was that earlier studies that focused on strict blood sugar control showed very little, if any, effect on cardiovascular health.

This finding led the authors of the study to speculate that it was the “newer agents” found in the drugs that made the difference. According to Faramarz Ismail-Beigi, MD, one of the authors of the new review paper, this finding might necessitate a “paradigm shift” in the treatment of Type 2 diabetes. As he put it, “We propose that we must shift from our previous paradigm with its monocular focus on control of blood glucose and hemoglobin A1C, to one of control of blood glucose plus preventing cardiovascular disease and death from cardiovascular causes.” He went on to say that when the U.S. Food and Drug Administration (FDA), approves new diabetes medications it might consider not just whether a drug helps control blood sugar but also whether it reduces mortality from heart disease.

Want to learn more about diabetes and heart health? Read “Fight Off Heart Disease With These Heart-Healthy Foods” and take our heart disease quiz.

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