Your browser doesn't support javascript.
loading
Utilizing synchronous care to improve cardiovascular and renal health among patients with type 2 diabetes: Proof-of-concept results from the DECIDE-CV clinical programme.
Marques, Pedro; Mavrakanas, Thomas A; Guida, Julian; Gédéon, Tara; Emami, Anahita; Alaamiri, Abdulkhaliq; Ho, Daniel; Possik, Elite; Zhang, Guang; Tsoukas, Michael A; Sharma, Abhinav.
Afiliação
  • Marques P; Division of Nephrology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Mavrakanas TA; DREAM-CV Lab, Centre for Outcomes Research, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
  • Guida J; Division of Cardiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Gédéon T; Division of Nephrology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Emami A; DREAM-CV Lab, Centre for Outcomes Research, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
  • Alaamiri A; Division of Cardiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Ho D; Division of Cardiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Possik E; Division of Cardiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Zhang G; Division of Cardiology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada.
  • Tsoukas MA; DREAM-CV Lab, Centre for Outcomes Research, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
  • Sharma A; DREAM-CV Lab, Centre for Outcomes Research, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
Diabetes Obes Metab ; 26(8): 3448-3457, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38831564
ABSTRACT

AIM:

The management of patients with type 2 diabetes is asynchronous, i.e. not coordinated in time, resulting in delayed access to care and low use of guideline-directed medical therapy (GDMT).

METHODS:

We retrospectively analysed consecutive patients assessed in the 'synchronized' DECIDE-CV clinic. In this outpatient clinic, patients with type 2 diabetes and cardiovascular or chronic kidney disease are simultaneously assessed by an endocrinologist, cardiologist and nephrologist in the same visit. The primary outcome was use of GDMT before and after the assessment in the clinic, including sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, renin-angiotensin system blockers and mineralocorticoid receptor antagonists. Secondary outcomes included the baseline-to-last-visit change in surrogate laboratory biomarkers.

RESULTS:

The first 232 patients evaluated in the clinic were included. The mean age was 67 ± 12 years, 69% were men and 92% had diabetes. In total, 73% of patients had atherosclerotic cardiovascular disease, 65% heart failure, 56% chronic kidney disease and 59% had a urinary albumin-to-creatinine ratio ≥30 mg/g. There was a significant increase in the use of GDMTsodium-glucose cotransporter 2 inhibitors (from 44% to 87% of patients), glucagon-like peptide 1 receptor agonists (from 8% to 45%), renin-angiotensin system blockers (from 77% to 91%) and mineralocorticoid receptor antagonists (from 25% to 45%) (p < .01 for all). Among patients with paired laboratory data, glycated haemoglobin, urinary albumin-to-creatinine ratio and N-terminal proB-type natriuretic peptide levels significantly dropped from baseline (p < .05 for all).

CONCLUSIONS:

Joint assessment of patients with diabetes in a synchronized cardiometabolic clinic holds promise for enhancing GDMT use and has led to significant reductions in surrogate cardiovascular and renal laboratory biomarkers.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares / Diabetes Mellitus Tipo 2 / Nefropatias Diabéticas / Insuficiência Renal Crônica Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares / Diabetes Mellitus Tipo 2 / Nefropatias Diabéticas / Insuficiência Renal Crônica Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article