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The diabetes epidemic will also cause an upsurge in cardiovascular events, such as heart attacks and strokes. Of the 4 million Italian diabetics, 400,000 are already suffering from a myocardial infarction and 250,000 are suffering from a stroke. High blood sugar levels, hypertension and obesity badociated with diabetes increase the risk of developing cardiovascular disease, the leading cause of death badociated with diabetes. And heart failure is the most common cause of hospitalization in diabetics. In recent years, in addition to glycemic control, cardiovascular complications are becoming more and more of a concern.
It is already provided in the European and American guidelines on the treatment of diabetes to customize the treatment according to the risk of occurrence of cardiovascular events in each patient. Clinicians now have new diabetes medications that are also effective in terms of cardiovascular and renal protection. This was also discussed at the American Heart Association conference, which brought together cardiologists from around the world in Chicago and confirmed the need to pay attention to the heart and kidneys in the treatment of the diabetic patient.
A study was presented in Chicago, Declare, published in the New England Journal of Medicine and conducted for five years in 33 countries out of a total of more than 17,000 patients with type 2 diabetes who had a high cardiovascular risk or who already had heart disease. The molecule dapagliflozin, an inhibitor of Sglt2-2 that blocks the reabsorption of glucose and sodium by lowering blood sugar levels, has shown a statistically significant reduction in the number of hospitalizations for heart failure and death. Cardiovascular origin in a large patient population.
"These results are clinically relevant for the 3 million patients with type 2 diabetes in Italy who are at risk of heart failure and cardiovascular disease 2- to 5-fold higher than non-diabetic subjects," he said. Stefano. Del Prato, director of the Operational Unit of Metabolic Diseases and Diabetology of the University Hospital of Pisa. "Heart failure is the leading cause of hospitalization in Italy and, 5 years after diagnosis, only 50% of cardiac patients survive.
This is why the results of the Declare study, obtained in a population very close to that of our clinics, are of particular interest and underline the need to go beyond the goal of glycemic control for a more integrated approach. diabetes and its consequences. cardiac and renal complications ".
"The Declare study, in addition to cardiovascular safety, showed a significant reduction in the risk of heart failure or cardiovascular death and a nephrotective effect throughout the entire enrolled population, even in patients with primary prevention and with the same effectiveness – said Andrea Giaccari, head of the Center for Endocrine and Metabolic Diseases at the A. Gemelli University Hospital of the IRCCS Policlinico and the 39 Catholic University of the Sacred Heart of Rome – These data, badociated with the good safety profile, also recommend the early use of dapagliflozin they require reflection on new models of care and taking in charge of these patients ".
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