Magazine article Clinical Psychiatry News

Groups Unite to Prevent Heart Disease in Diabetes

Magazine article Clinical Psychiatry News

Groups Unite to Prevent Heart Disease in Diabetes

Article excerpt

Diabetologists and cardiologists are joining forces to address the issue of cardiovascular disease in patients with diabetes.

In North America, new joint guidelines from the American Heart Association (AHA) and the American Diabetes Association (ADA) focus on the primary prevention of cardiovascular disease in patients with diabetes (Circulation 2007;115:114-26; Diabetes Care 2007;30:162-72). "People with ... diabetes are at increased risk for [cardiovascular disease] and have worse outcomes after surviving a CVD event," wrote coauthor Dr. John Buse, director of the diabetes care center at the University of North Carolina at Chapel Hill, and his colleagues.

And in Europe, the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) have issued guidelines on diabetes, prediabetes and cardiovascular diseases (Eur. Heart J. 2007;28:88-136). "Diabetes and cardiovascular disease often appear as two sides of a coin," wrote coauthor Dr. Lars Ryden from Karolinska University Hospital, Stockholm, and colleagues. "Thus it is high time that diabetologists and cardiologists join forces.... The cardio-diabetologic approach not only is of utmost importance for the sake of ... patients but [is] also instrumental for further progress in the fields of cardiology and diabetology."

Although both the North American and European documents recognize the importance of harmonizing the approaches of cardiologists and diabetologists, they both also focus on specific and different aspects of the diabetes-cardiovascular disease dyad, making them potentially complementary. In both documents, special attention is placed on the early stages of disease development, but the European document focuses on the role of prediabetes in early cardiovascular dysfunction, whereas the North American document emphasizes primary prevention of cardiovascular disease in patients with overt diabetes.

The importance of the ADA/AHA document is not so much its content, but rather its existence, suggested Dr. Daniel Einhorn, medical director of the Scripps Whittier Institute for Diabetes, an endocrinologist at the University of California, San Diego, and a spokesperson for the American Association of Clinical Endocrinologists (AACE).

"This is not a brand new piece of science that will suddenly change the way we practice, but it confirms in an organizational way what we know, and I can tell you that AACE will agree with it right down the board," he said in an interview. …

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