Type 2 Diabetes and Cardiovascular Disease – Connections and Risks

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Today, Canadians living with diabetes are three times more likely to die of heart disease.  A leading expert in cardiovascular disease and diabetes, Dr. Mansoor Husain, cardiologist and Executive Director of the Ted Rogers Centre for Heart Research, shares insights into needs and trends he’s seeing first-hand.

What do you see as the greatest issue impacting type 2 diabetes (T2D) and cardiovascular disease today?

We have a knowledge translation gap.  Today, we are fortunate enough to have good scientific data that demonstrates the efficacy of treatments in managing T2D and cardiovascular disease.  However, it’s not being implemented.  Data clearly demonstrates specific therapies can have significant impact on reducing disease complications and risks.  We need to continue to educate the public, healthcare practitioners and health system payers to proactively adopt clinically defined standards of care.

Are there any trends or common themes you see in your daily interactions with patients?

COVID-19 has been a challenging time for many.  Some patients are spending more time working from home and aren’t as physically active.  This can lead to stress and weight gain, which can negatively impact disease care.  We need to double our efforts post-pandemic to ensure patients are using the best therapies available to support optimal disease management.  Telemedicine will continue.  However, it’s not always easy to discuss new therapies and treatment changes in a virtual environment.  Unfortunately, there continues to be misinformation surrounding disease care.  While having significant benefits, social media can also lead to misinformation.  For instance, some mistakenly believe that naturopathic medicine can cure serious diseases such as diabetes.  There’s still a trend of anti-science and anti-knowledge that worries me and this needs to be combatted with evidence-based research, insights from real world data and clinical practice guidelines.

While I’ve seen first-hand how difficult it can be for patients to maintain a heathy lifestyle, it’s also been extremely challenging for healthcare professionals during the pandemic.  I’m more efficient when I have a patient physically in front of me, but in a telemedicine visit, it can take more time.  Nothing can replace the connection a physician and patient experience in-person.  There is the age-old cliché of a “bedside manner” in medicine which comes from physical interaction.  I find myself spending more time trying to connect with my patients to get a feel for what is going on.  I’ve never worked harder in trying to manage my patients during COVID-19.

Is there anything T2D patients could do to lessen their major adverse cardiovascular events (MACE) risks?

Patients must continue to do the things they were taught when they were first diagnosed with diabetes:

  1. Regular exercise such as a daily 30-minute walk – rain or shine.
  2. Continue to monitor their weight and be mindful of what they’re eating and drinking.
  3. Be aware of calorie density before consuming, so they can stay on-track, managing their condition effectively.

What is the most important take away for patients living with type 2 diabetes and cardiovascular disease?

Canadians living with diabetes, prediabetes or cardiovascular risks should proactively watch their blood pressure, cholesterol and activity levels.

If there’s one measurement that should be checked daily, it’s weight.  Observing weight, calorie intake and exercise are things we can all do.  Weight is particularly important because any weight gain can only be prevented or reversed if you’re on top of it.

Cardiovascular disease is caused by a combination of risk factors which include family history, smoking, blood pressure, cholesterol, obesity, and diabetes.  It’s important to manage all these risk factors and to make sure that people with diabetes are using treatments that have proven benefits.

I do feel a sense of optimism today.  There’s excitement knowing that we have treatments that are making a real difference for my patients.  It’s a rare experience in my career to see a paradigm shift.  But, the work here is not done.  We must continue to ensure we don’t fail to take advantage of the knowledge in managing diabetes and cardiovascular disease and help guide Canadians to lead healthier and active lifestyle’s, while managing their diabetes and cardiovascular disease effectively.

For more information on type 2 diabetes and cardiovascular disease visit Diabetes Canada’s Clinical Practice Guidelines.

Dr. Mansoor Husain is Executive Director of the Ted Rogers Centre for Heart Research and Professor of Medicine at the University of Toronto. He is also an Attending Staff Cardiologist at University Health Network.  Dr. Husain completed post-doctoral research training in the Program of Excellence in Cardiovascular Biology at the Massachusetts Institute of Technology. His research is focused on the mechanisms of cardiovascular diseases such as hypertension, atherosclerosis and heart failure, with a particular emphasis on identifying new therapies.

* Disclosure – Dr. Husain has not been compensated for this article.  Dr. Husain has been compensated as a consultant, speaker and researcher for various research-based pharmaceutical companies.

** This content is proudly sponsored by Novo Nordisk Canada Inc.