Patterns and Prevention of Cardiovascular Diseases - report from EASD 2026

It was a session on cardiovascular prevention in diabetes.

As you all know, uh, patients with diabetes have a very high risk to, to, uh, to get a cardiomyocardial infarction, cardiovascular diseases, stroke, uh, but also heart failure.

And, uh, the number one, uh, killer is still cardiovascular disease, also in patients with diabetes who have around about a double risk of cardiovascular disease compared to, uh, patients without diabetes.

And so they were shown some s- some studies that, uh, therapy improves, of course.

We have now many great medication which, uh, have the possibility to reduce cardiovascular risk.

But still, uh, even if, um, mortality f- for example, after acute myocardial infarction decreases in many countries, also f- uh, the mortality after one year and the long-term mortality, but it's still higher than in the patients, in the people without diabetes.

So it's still a, a big problem.

And, uh, we also now know that we have this, um, uh, common ground of kidney disease, heart failure, cardiovascular disease, diabetes, and it often starts with adiposity.

So, um, uh, the, the, uh, adiposity with complications with organ dysfunction is often the start.

Then they have pre-diabetes, diabetes, and then all the other complications.

And one very interesting study presented by my co-chair in this session, Nabid Sadam, uh, he-- it was a big study, but, uh, u- using electronic, um, uh, record databases systems from US, from UK, but also from Japan, so a big analysis.

Uh, and, uh, they, they showed-- They, they wanted to, to see what comes first if patients have Type 2 diabetes, um, kidney disease, or heart failure in this cardio-kidney-metabolic-liver [laughs] complex disease, uh, what comes first.

And, um, they showed that, uh, in the majority of patients, ki- kidney disease comes first.

And, um, for example, within five years of Type 2 diabetes diagnosis, uh, the risk of kidney disease was higher, but the composite of kidney disease, heart failure, and death, uh, after ten years, it was around 55% in all patients.

So no matter what comes first, the risk to also develop the, the alternate, uh, complication is very high and, um, uh, in the end, um, people die from kidney and cardiovascular disease.

So it's very, very important to screen for complications as early as possible to look for the albuminuria, uh, creatinine ratio, and to, to give the protective medications to lower blood pressure and to target dyslipidemia in order to, uh, improve the, uh, the life of the patients, the quality of life, and also to reduce, uh, the mortality rates.

And so no matter what comes first, also always look at the other complication.

For example, for heart failure, we have, uh, NT-proBNP, which we can measure, and then, uh, we have screening programs, uh, recommended by the European Society of Cardiology, how we should look for cardiomyopathy, for example.

Yeah, and there was also another very interesting, uh, study presented in my In my session, they looked at, uh, they looked at undiagnosed cardiomyopathy in patients with diabetes following, uh, the screening algorithm, uh, suggested by the European Society of Cardiology, and they found that 14% of the patients with diabetes had undiagnosed cardiomyopathy.

So again, please try to follow the guidelines and the recommendations and to protect your patients.