Cardio-renal-metabolic disease in primary care setting

Mahmoud Ibrahim*, Ebtesam M Ba-Essa, Jason Baker, Avivit Cahn, Antonio Ceriello, Francesco Cosentino, Melanie J Davies, Robert H Eckel, Luc Van Gaal, Peter Gaede, Yehuda Handelsman, Samuel Klein, Richard David Leslie, Paolo Pozzilli, Stefano Del Prato, Francesco Prattichizzo, Oliver Schnell, Petar M Seferovic, Eberhard Standl, Abraham ThomasJaakko Tuomilehto, Paul Valensi, Guillermo E Umpierrez

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Abstract

In the primary care setting providers have more tools available than ever before to impact positively obesity, diabetes, and their complications, such as renal and cardiac diseases. It is important to recognise what is available for treatment taking into account diabetes heterogeneity. For those who develop type 2 diabetes (T2DM), effective treatments are available that for the first time have shown a benefit in reducing mortality and macrovascular complications, in addition to the well-established benefits of glucose control in reducing microvascular complications. Some of the newer medications for treating hyperglycaemia have also a positive impact in reducing heart failure (HF). Technological advances have also contributed to improving the quality of care in patients with diabetes. The use of technology, such as continuous glucose monitoring systems (CGM), has improved significantly glucose and glycated haemoglobin A1c (HbA1c) values, while limiting the frequency of hypoglycaemia. Other technological support derives from the use of predictive algorithms that need to be refined to help predict those subjects who are at great risk of developing the disease and/or its complications, or who may require care by other specialists. In this review we also provide recommendations for the optimal use of the new medications; sodium-glucose co-transporter-2 inhibitors (SGLT2i) and Glucagon-like peptide-receptor agonists 1 (GLP1RA) in the primary care setting considering the relevance of these drugs for the management of T2DM also in its early stage.

OriginalsprogEngelsk
Artikelnummere3755
TidsskriftDiabetes/Metabolism Research and Reviews
Vol/bind40
Udgave nummer3
Tidlig onlinedato19 dec. 2023
DOI
StatusUdgivet - mar. 2024

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© 2023 John Wiley & Sons Ltd.

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