Residual risk

Current treatment recommendations do not fully address residual risk attributable to type 2 diabetes

The ADA-recommended multifactorial approach has shown clear benefits associated with modifying cardiovascular risk factors in patients. Their approach includes1,2:

  • Lifestyle modification
  • Antiplatelet therapy
  • Blood pressure control
  • Glycaemic control
  • Management of dyslipidaemia

Despite optimal treatment, patients with type 2 diabetes still have residual risk of cardiovascular disease and microvascular disease.3

  • With better management of glucose levels and cardiovascular risk factors over the past 20+ years, overall diabetes-related complication rates have declined. However, due to the continued increase in the prevalence of type 2 diabetes, risk of death from CVD and complication rates are still much higher in patients with diabetes compared with those without diabetes.9,10

MI=myocardial infarction.

Aggressive therapy falls short when it comes to reducing cardiovascular risk

  • Several large studies indicate that aggressive HbA1c reductions do not always correlate with reduced cardiovascular risk 11,12
  • Even intensive therapy for cardiovascular disease leaves residual cardiovascular risk in patients with diabetes (STENO-2 study)13,14

o In the STENO-2 study, intensive therapy reduced the risk of death from cardiovascular disease by 62%; however patients still experienced cardiovascular events.13

Note: This figure illustrates the cumulative incidence of the composite cardiovascular or death endpoint.

Despite treatment with intensive, multifactorial therapy, patients still experienced events; therefore, residual risk remains.13