Ian Neeland, M.D. Answers Questions On: Diabetes and Heart Disease
What is the relationship between diabetes and heart disease?
What does your team offer to help lower the risk of diabetes-related cardiovascular disease?
We approach it from a comprehensive standpoint, which can include lifestyle, medical, and surgical therapies such as bariatric (weight-loss) surgery.
Lifestyle therapies include access to nutritionists, diabetes educators, and exercise physiologists. So, for example, we may prescribe a structured exercise program and/or purposeful, targeted weight loss – usually 5 to 10 percent of a person’s body weight, which we know lowers risk and improves health outcomes.
Medical therapies include the new drugs empagliflozin and liraglutide – both of which can treat both diabetes and the heart-related issues that can come with it, including weight gain, abnormal blood pressure, fluid overload, and lung congestion, which can lead to heart attacks and heart failure.
Historically, aggressively treating diabetes with drugs designed to lower blood glucose levels has improved outcomes in patients with microvascular complications that affect, for example, the eyes and the kidneys. But these traditional diabetes drugs haven’t done much to reduce the risk of macrovascular complications that impact the large arteries, including those in the heart.
These new drugs, however, are doing just that, and many similar drugs are in the pipeline.
There are also specific medications aimed at weight loss that can help people who need to make lifestyle changes reach their goals. We help to determine which of these drugs can benefit patients with heart disease and which could be dangerous.