Diabetes and CVD

Welcome to this modular e-learning programme looking at the treatment of diabetes in patients with cardiovascular disease (CVD).

CVD is a common cause of morbidity and mortality in people with diabetes. It is also recognised that patients with established CVD have a high prevalence of undiagnosed diabetes, and up to one third will have prediabetic states. Atherosclerotic events are reducing in people with diabetes as a consequence of the widespread use of statins and antihypertensive medications, and heart failure is now the most common first presenting cardiovascular condition in people with type 2 diabetes.

Older therapies for type 2 diabetes have shown disappointing results with regards to effects on cardiovascular outcomes. There are now three major new groups of drugs to treat people with diabetes: DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT2 inhibitors. Many of these drugs have been studied in cardiovascular outcome trials, and several GLP-1 receptor agonists and SGLT2 inhibitors have been proven to reduce cardiovascular and renal events. Further trials have been performed with SGLT2 inhibitors in patients with heart failure and patients with chronic kidney disease and have demonstrated benefits in these populations.

This modular programme is primarily intended for non-diabetes practitioners but will also serve as a guide for trainees and others grades within the diabetes community. It is intended to explain the complexities of diabetes management in a digestible format.

In this modular programme, we will first be introduced in Module 1 to the epidemiology of diabetes and its cardiovascular consequences. Module 2 will discuss the clinical pharmacology of currently available anti-diabetes therapies and practical considerations for prescribing, including in populations with cardiovascular or renal disease. Module 3 will describe the cardiovascular outcome trials with the incretin-based therapies which are the DPP-4 inhibitors and GLP-1 receptor agonists. Module 4 will summarise the outcome trials of SGLT2 inhibitors in patients with diabetes, chronic kidney disease, and heart failure.

Each module will have a series of multiple-choice questions. Its 5 hours of learning will lead to 5 continuing professional development (CPD) credits

Novo Nordisk have provided sponsorship to support the development of this e-learning programme. Novo Nordisk have had no input into the content of this programme.

Contributors
Professor Miles Fisher, Honorary Professor, University of Glasgow, Glasgow
Dr Andrea Llano, Consultant Physician and Clinical Pharmacologist, Glasgow Royal Infirmary, Glasgow
Professor Gerard McKay, Consultant Physician and Clinical Pharmacologist, Glasgow Royal Infirmary, Glasgow