Cardio-renal-metabolic disease in primary care setting.
Mahmoud IbrahimEbtesam M Ba-EssaJason BakerAvivit CahnAntonio CerielloFrancesco CosentinoMelanie Jane DaviesRobert H EckelLuc Van GaalPeter Haulund GaedeYehuda HandelsmanSamuel KleinRichard David LesliePaolo PozzilliStephano Del PratoFrancesco PrattichizzoOliver SchnellPetar M SeferovićEberhard StandlAbraham ThomasJaakko TuomilehtoPaul ValensiGuillermo E UmpierrezPublished in: Diabetes/metabolism research and reviews (2023)
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.
Keyphrases
- primary care
- type diabetes
- glycemic control
- risk factors
- heart failure
- early stage
- cardiovascular disease
- healthcare
- blood glucose
- quality improvement
- palliative care
- insulin resistance
- left ventricular
- machine learning
- general practice
- rheumatoid arthritis
- metabolic syndrome
- weight loss
- cardiovascular events
- squamous cell carcinoma
- pain management
- atrial fibrillation
- weight gain
- deep learning
- single cell
- radiation therapy
- physical activity
- combination therapy
- ankylosing spondylitis
- cardiac resynchronization therapy
- coronary artery disease
- skeletal muscle