Cardiologists are treating more and more patients with established cardiovascular disease and diabetes. Diabetes, particularly type 2 diabetes, is common in patients with an array of cardiovascular disorders including coronary artery disease, peripheral vascular disease, congestive heart failure and stroke. Over the last decade, studies have shown that patients with diabetes are at greater risk of dying from these cardiovascular diseases than those without diabetes.

“We know that few patients with type 2 diabetes, even in the U.S., despite its sophisticated health care systems, attain guideline–directed goals for the conventional cardiovascular risk factors including lipids, blood pressure, blood glucose and weight, and when inadequately controlled, lead to significant residual risk for cardiovascular complications,” said Norman Lepor, MD, FACC, in a recent article in the journal Cardiology.

Several important randomized trials show medical interventions in cardiovascular patients with diabetes can provide protective benefits. In the EMPA–REG OUTCOME trial, empagliflozin reduced the incidence of the composite endpoint of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke by 14 percent, while death from cardiovascular–related causes was reduced by 38 percent. Heart failure was also reduced by 35 percent. In the SUSTAIN–6 trial evaluating semaglutide, death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, was reduced by 26 percent compared with patients on placebo. Nonfatal stroke was reduced by 39 percent. Results from the LEADER trial showed liraglutide reduced death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke by 13 percent. Death from cardiovascular causes was reduced by 22 percent.

According to Nathan D. Wong, PhD, FACC, it is critical going forward that cardiologists not only employ a team–based approach in collaborating with endocrinologists and other providers managing patients with diabetes, but also to understand the cardioprotective effects of the newer diabetes therapies that could take a leading role in reducing cardiovascular risk in their diabetic patients.

To help in the effort to better combine forces between cardiologists and diabetologists, the ACC, in partnership with the American Diabetes Association, American College of Physicians, American Association of Clinical Endocrinologists, and Joslin Diabetes Center, created the first worldwide Diabetes Collaborative Registry.