Guidelines, KIDGO, ADA, and IDF
Professor Antonio Ceriello
Chronic kidney disease (CKD) in diabetes demands early detection and a multidisciplinary approach. Managing CKD is complex, requiring a multidisciplinary approach. Guidelines stress early detection and intervention, emphasizing the involvement of various disciplines. Recommendations include interventions like blood pressure and glycemic control, proteinuria reduction, and lifestyle changes such as diet, exercise, and smoking cessation. Regular kidney function monitoring is advised, with nephrologist referral for advanced CKD or complications. Overall, CKD management guidelines underscore early detection and a comprehensive, collaborative approach.
Do DPP4 inhibitors and GLP-1R Agonists have Any Role in Ttreating Diabetic Kidney Disease?
Johannes F.E. Mann
Chronic kidney disease (CKD) affects 40% of individuals with type 2 diabetes (T2D), leading to severe outcomes like cardiovascular events, kidney failure, and reduced survival. GLP1RA trials, such as liraglutide, dulaglutide, and semaglutide, showed potential in preserving glomerular filtration rate independently of traditional factors like weight, blood pressure, and HbA1c. Combining SGLT-2 inhibitors with GLP1RA might have additive effects on kidney outcomes. In contrast, DPP4 inhibitors, while reducing albuminuria moderately, lack extensive testing on broader kidney outcomes.
CV Risk Scores in Diabetes, if so Which Ones, and When?
Jannick Dorresteijn
Individuals with type 2 diabetes (T2DM) face a two- to fourfold higher risk of developing cardiovascular disease (CVD) during their lifetime, particularly those with established atherosclerotic cardiovascular disease (ASCVD) or severe target organ damage (TOD). For T2DM patients aged 40-69 without ASCVD or severe TOD, the updated SCORE2-Diabetes algorithm is recommended to estimate 10-year CVD risk. This tool, available through the ‘ESC CVD risk calculation’ app, accurately predicts risk and guides preventive treatment targets based on categorized risk levels: low (<5%), moderate (5-10%), high (10-20%), or very high (>20%). Additionally, models like DIAL2 and SMART-REACH can assist in communicating lifetime risk and individual treatment effects, promoting shared decision-making.
Novel Biomarkers in Diabetes
Paul
Biomarkers serve as indicators of cardiovascular risk. In cardiometabolic research, certain biomarkers like CRP, high sensitivity troponin, and NT-proBNP are increasingly recognized for their risk-enhancing properties and may be used in trial inclusion criteria. Notably, NT-proBNP is of interest for monitoring heart failure in diabetes patients. This session aims to update participants on recent advances in understanding how cardiometabolic biomarkers guide cardiovascular risk monitoring in diabetes patients and their potential role in selecting interventions for future clinical trials.
Suboptimal Screening of Eye and Kidney Disease in LMIC: Some Solutions from India
Dr. V. Mohan
The rising prevalence of diabetes in low- and middle-income countries, exemplified by India with 101 million people affected, is anticipated to lead to an increased burden of microvascular complications such as diabetic retinopathy (DR) and diabetic kidney disease (DKD). Both conditions, often asymptomatic until advanced stages, contribute significantly to the social and economic healthcare burden. To address this, regular screening for DR and DKD is crucial, especially in diabetes clinics, as symptoms usually prompt individuals to seek specialist care too late. Telemedicine, particularly tele-ophthalmology, has proven effective in remote rural areas where access to specialists may be limited, providing a valuable strategy for early complication screening.
Predictive Model to Classify Early-Onset vs Late-Onset Type 2 Diabetes
Yubi Mamiya, Tinney Mak
The study aimed to develop a predictive model classifying Early-Onset vs Late-Onset Type 2 Diabetes (T2D) by analyzing baseline biometric data from 17,039 T2D patients at the University of Malaya Medical Center. The results revealed that patients’ HbA1C, blood pressure, and LDL-Cholesterol levels at baseline significantly predicted the classification of T2D onset. Specifically, early-onset T2D patients demonstrated higher levels of HbA1C and LDL-Cholesterol compared to late-onset patients. The study suggests that these baseline characteristics can inform more accurate onset classification and diagnosis models, enabling clinicians to provide personalized treatment based on the unique risks associated with the onset of the disease.
Once weekly Semaglutide in Type 2 Diabetes Patients with Heart Failure with Reduced Left Ventricular Ejection Fraction
Alicia Trenas-Calero
The study aimed to analyze the efficacy of once-weekly semaglutide in Type 2 Diabetes (T2D) patients with Heart Failure (HF) with reduced left ventricular ejection fraction (HFrEF). It employed a real-world observational design with a primary outcome of HF events at 52 weeks. The analysis, using propensity score matching, revealed that once-weekly semaglutide was associated with reductions in HF events and other adverse events in T2D patients with HFrEF. The study suggests a need for further research and randomized clinical trials on GLP-1ra in HF to provide more evidence of their efficacy.
Dyslipidemia in Young Patients with Type 2 Diabetes and Maturity Onset Diabetes of the Young; An Observational Study
Dr. Moomin Hussain Bhat
The study focused on youth-onset Type 2 Diabetes (T2D) and maturity-onset diabetes of the young (MODY), evaluating dyslipidemia as a modifiable cardiovascular risk factor. Results showed significantly higher total cholesterol and LDL levels in T2D compared to MODY patients, while HDL levels were lower in T2D. About 53.3% of T2D and 36.4% of MODY patients had elevated LDL-C (>100 mg/dL), emphasizing the need for more aggressive dyslipidemia screening and treatment in youth with diabetes, particularly in the T2D population. The study suggests a higher prevalence of dyslipidemia in youth T2D compared to MODY.
Effect of Self-management Education on Glycemic Control of Individuals with Type 2 Diabetes
H. Gunawardena
The study aimed to evaluate the impact of self-management education on glycaemic control in individuals with type 2 diabetes (T2DM). A total of 60 participants were divided into two groups: Diabetes Self-Management Education (DSME) and General Education Program (GEP). The 15-week follow-up revealed positive changes in body weight, waist circumference, and a significant reduction in HbA1c for the DSME group compared to the GEP group. The conclusion suggests that diabetes self-management education effectively improves glycaemic control in individuals with T2DM.
Estimation and Physical activity profiling in Individuals with Young onset Diabetes Mellitus
Anupama Harihar
The findings revealed that 17% had young-onset T2DM, with a majority being physically inactive. The study recommends encouraging physical activity in the management of young-onset diabetes, emphasizing its role in delaying progression and preventing complications. Global estimates indicate a rising incidence of T2DM in individuals under 40, with physical inactivity associated with higher risks. The study underscores the importance of promoting physical activity in this high-risk group.
