Less than 20 per cent of Americans with type 2 diabetes are reducing their risk of heart disease, with leading medics calling for “urgent” action.
With many of those struggling to stop smoking or lose weight, which increases their risk of heart disease, the American Heart Association has said that people working in the health industry and community organisations all have an “important role to play”.
The warning came as the Association published a scientific statement – an expert analysis of current research which could shape future clinical guidelines.
Tackling barriers to care, including health-related behaviours, socioeconomic factors, environmental factors and structural racism, should be combined with therapies to help support those with type 2 diabetes, the Association says.
Joshua J. Joseph, chair of the statement writing group and an assistant professor at The Ohio State University College of Medicine, said: “This new scientific statement 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 (CVD) risk.
“Far too few people – less than 20 per cent 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 CVD risk factors. Health care professionals, the health care industry and broader community organisations all have an important role to play in supporting people with type 2 diabetes.”
More than 34m people in America have type 2 diabetes, which accounts for nearly 11 per cent of the population. Those with the condition often have other CVD risk factors, including obesity and high blood pressure. Having type 2 diabetes makes them twice as likely to die from CVD compared to those who don’t.
The statement from the American Heart Association looks at the difference between the evidence on how to reduce the risk of CVD in people with type 2 diabetes (T2D), and the reality for those individuals.
Around 90 per cent of factors which could reduce the risk are modifiable lifestyle and societal factors.
Assistant Professor Joseph said: “In the United States, less than 1 in 5 adults with T2D not diagnosed with cardiovascular disease are meeting optimal T2D management goals of not smoking and achieving healthy levels of blood sugar, blood pressure and low-density lipoprotein (LDL) cholesterol, also known as ‘bad’ cholesterol.
“Social determinants of health, which includes health-related behaviours, socioeconomic factors, environmental factors and structural racism, have been recognised to have a profound impact on cardiovascular disease and type 2 diabetes outcomes.
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“People with T2D face numerous barriers to health including access to care and equitable care, which must be considered when developing individualised care plans with our patients.”
The statement also points to recent evidence around the treatment of type 2 diabetes:
- New ways to control blood sugar, including the use of GLP-1 medications and SGLT-2 inhibitors
- Personalised blood pressure control
- Importance of lowering cholesterol levels
- Re-thinking aspirin use – examining whether daily low-dose aspirin is still appropriate.
The study has been published in the journal Circulation.
