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AHA statement finds few with diabetes reduce heart disease risk

Ohio State endocrinologist Joshua J. Joseph chairs scientific statement writing group

A scientific statement issued today by the American Heart Association finds that fewer than 1 in 5 adults with Type 2 diabetes in the United States are meeting targets to reduce heart disease risk. However, available therapies can help when combined with new approaches that address social determinants of health and other barriers to care.

The scientific statement, published in the journal Circulation, is based on the writing group’s extensive review of clinical trial results through June 2020. The statement addresses the gap between existing evidence on how best to lower cardiovascular disease (CVD) risk in people with Type 2 diabetes and the reality for people living with the disease. 

“This is an urgent call to action to follow the latest evidence-based approaches and to develop new best practices to advance Type 2 diabetes treatment and care and reduce cardiovascular disease risk,” said Dr. Joshua J. Joseph, chair of the statement writing group and an endocrinologist at The Ohio State University Wexner Medical Center.

“Far too few people – less than 20% of those with Type 2 diabetes – are successfully managing their heart disease risk, and far too many are struggling to stop smoking and lose weight, two key cardiovascular disease risk factors. Health care professionals, the health care industry and broader community organizations all have an important role to play in supporting people with Type 2 diabetes,” said Joseph, who is also an assistant professor of medicine in the division of endocrinology, diabetes and metabolism in The Ohio State University College of Medicine.

Targets to reduce CVD risk among people with Type 2 diabetes include managing blood glucose, blood pressure and cholesterol levels; increasing physical activity; healthy nutrition; healthy weight management; not smoking; not drinking alcohol; and psychosocial care. Greater adherence to an overall healthy lifestyle among people with Type 2 diabetes is associated with a substantially lower risk of cardiovascular disease and cardiovascular disease mortality. 

“Social determinants of health, which include health-related behaviors, socioeconomic factors, environmental factors and structural racism, have been recognized to have a profound impact on cardiovascular disease and Type 2 diabetes outcomes,” Joseph said. “People with Type 2 diabetes face numerous barriers to health, including access to care and equitable care, which must be considered when developing individualized care plans with our patients.”

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