Help your patients make the connection between T2D and CVD

Talking to your patients using language that is easy for them to understand and remember is important, and may help them take a more active role in their treatment plan. The information below can help as you navigate the discussion on the connection between type 2 diabetes (T2D) and cardiovascular disease (CVD).

For patients with T2D, CVD is the #1 cause of death1


Tips for educating patients: Explain how high blood sugar can damage the heart

Helping your patients make the connection between T2D and CV risk can support them during their treatment path, allowing them to stay actively engaged and become an advocate for their health. Below are some key points to address using language that may be easier for your patients to understand:

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Over time, high blood sugar can cause damage to blood vessels and nerves5-7

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This damage puts patients at greater risk for CVD5-7

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The longer they have T2D, the greater their risk for developing CVD8,9

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Reduc­tions in A1C do not equal reduc­tions in CVD risk

THE IMPACT OF TIGHT GLYCEMIC CONTROL ON CV RISK:

  • Has been shown to improve microvascular outcomes, but there is no such consensus with relation to macrovascular disease10
  • Several landmark trials have investigated the microvascular and macrovascular effects of pursuing a more intensive treatment strategy to achieve an A1C level of <6.5% or <6.0%10
  • These trials did not demonstrate a statistically significant reduction in their primary composite macrovascular endpoints10

Risk of first CVD event

Risk of second event

Even when treated with both diabetes and cardiovascular therapies, approximately 1 in 6 people may still experience a CV event such as a heart attack or stroke.11

Research has shown that compared with people without diabetes, 60% more people had a secondary CV event.12

Risk of first CVD event

Even when treated with both diabetes and heart medicines, approximately 1 in 6 people may still experience a CV event such as a heart attack or stroke.11

Risk of second event

Research has shown that compared with people without diabetes, 60% more people had a secondary CV event.12

Risk of death

In a separate study, about 2.5 years after an event, death occurred in approximately


Tips for educating patients: CVD can take many different forms14-16

Make sure your patients understand that if they have 1 or more of these conditions, they have CVD.

Select a condition to help your patients understand what form CVD can take:

Blood vessel diseases15,16,a Heart valve problem14
Heart rhythm problem14 Chest pain due to blockage in the arteries of the heart14-16,a
Weakened pumping of the heart14,a Narrowing of the arteries of the leg16,a
aPatients with T2D are more predisposed to these conditions.
Skeleton
close Blood vessel diseases15,16,a

Caused by a build-up of fatty deposits which narrow the arteries and veins that carry blood to and from the arms, legs, and abdomen.

close Heart rhythm problem14
BPM

Improper beating of the heart, whether irregular, too fast, or too slow.

close Weakened pumping of the heart14,a

The heart muscle is weak and gets stretched out, becoming less effective at pumping blood through the body.

close Heart valve problem14

One or more of the heart valves don’t open or close properly which can cause blood flow to be disrupted.

close Chest pain due to blockage in the arteries of the heart14-16,a

Caused by plaque buildup in the coronary arteries, decreasing blood flow to the heart. Eventually, the decreased blood flow may cause chest pain.

close Narrowing of the arteries of the leg16,a

A circulatory problem in which narrowed arteries reduce blood flow to the limbs.



There are medicines that can treat diabetes AND reduce CV risk17,18

Encourage your patients to continue taking their heart medicines as directed or prescribed

And discuss diabetes medicines that lower A1C AND reduce CV risk

See the full story Back

See the only GLP-1 RA recommended by the ADA to lower CVD event rates and mortality in patients with established CVD18

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Contact your Novo Nordisk representative to see if you are eligible to request a brochure featuring this information. Educational posters and tearpads are also available.

References:

  1. 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.
  2. Kalofoutis C, Piperi C, Kalofoutis A, et al. Type II diabetes mellitus and cardiovascular risk factors: Current therapeutic approaches. Exp Clin Cardiol. 2007;12(1):17-28.
  3. 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.
  4. Centers for Disease Control (CDC). Prevalence of self-reported cardiovascular disease among persons aged ≥35 years with diabetes—United States, 1997–2005. MMWR Morb Mortal Wkly Rep. 2007;56(43):1129-1132.
  5. He C, Yang J, Li Y, et al. Comparison of lower extremity atherosclerosis in diabetic and non-diabetic patients using multidetector computed tomography. BMC Cardiovasc Disord. 2014;14:1-7.
  6. Rydén L, Grant PJ, Anker SD, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2013;34:3035-3087.
  7. Zeadin MG, Petlura CI, Werstuck GH. Molecular mechanisms linking diabetes to the accelerated development of atherosclerosis. Can J Diabetes. 2013;37:345-350.
  8. 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.
  9. 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.
  10. Rees A. Excess cardiovascular risk in patients with type 2 diabetes: do we need to look beyond LDL cholesterol? Br J Diabetes Vasc Dis. 2014;14:10-20.
  11. Shepherd J, Barter P, Carmena R, et al. Effect of lowering LDL cholesterol substantially below currently recommended levels in patients with coronary heart disease and diabetes. Diabetes Care. 2006;29:1220-1226.
  12. 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.
  13. Jhund P, McMurray J, Chaturvedi N, et al. Mortality following a cardiovascular or renal event in patients with type 2 diabetes in the ALTITUDE trial. Eur Heart J. 2015;36:2463-2469.
  14. American Heart Association. What is cardiovascular disease? http://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease. Accessed September 18, 2018.
  15. Mayo Foundation for Medical Education and Research (MFMER). Heart disease. https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118. Accessed January 26, 2018.
  16. World Health Organization. Cardiovascular diseases (CVDs). http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Accessed September 18, 2018.
  17. 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 January 26, 2018.
  18. American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;41(suppl1): S1-S159.