Cardiovascular disease the biggest killer among type 2 diabetes patients - experts


People living with type 2 diabetes face a high risk of dying from cardiovascular diseases, a team of medical experts said in a medical event in Kuala Lumpur recently.

The experts comprised of Dr Zanariah Binti Hussein, Consultant Endocrinologist at Hospital Putrajaya; Dr Chan Siew Peng, Senior Consultant Endocrinologist; and Professor Dr. Chee Kok Han, Senior Consultant Cardiologist and Professor at the University of Malaya.

According to Dr Chan Siew Pheng, that 50% to 80 % of people with diabetes will die from heart disease and that it is the main cause of premature mortality. She also said that many people already have complications by the time they find out they have diabetes. Many of them develop microvascular complications prior to diagnosis. She also said that reducing the risk of complications gets more and more difficult as the duration of diabetes increases.

Diabetes are linked to problems to the heart, such as cardiovascular disease, systemic hypertension and diabetic cardiomyopathy.It is therefore important for people to seek early diagnosis and treatment before their ailment worsens.

In her presentation called ‘The Burden of Diabetes in Malaysia,’ Dr Zanariah Binti Hussein called diabetes a “global emergency”: currently 425 million worldwide suffer from diabetes, a figure which is expected to shoot up to 629 million by 2045. In Western Pacific alone, 159 million people are currently living with diabetes, and the number is predicted to increase to 183 million by 2045. In Malaysia alone, 1 in 6 adults have the condition.

Dr Zanariah pointed the link between type 2 diabetes with cardiovascular disease: 90% of type 2 sufferers are overweight or obese; 70% of them have hypertension and 70% have Dyslipidemia (an abnormal amount of lipids in the blood).

The number of diabetes patients exert a huge cost on Malaysia’s healthcare: RM 1.4 billion in total are spent by the government for diabetes care. This is from a total of RM2.04 billion (private and public healthcare sectors) per year for year 2011.

Aside for cardiovascular disease, other diabetes-related complications are stroke (increases risk from 2 to 6 fold), diabetic neuropathy, diabetic nephropathy (leading cause of end-stage renal disease) and diabetic retinopathy (which causes vision loss).

Dr Zanariah outlined a few key steps to tackle CV, and this includes: lifestyle modification (such as exercise), management of Dyslipidemia, controlling blood pressure, and glycaemic control.

The medical experts were speaking at a media briefing for Jardiance, a prescription medicine for adults with type 2 diabetes. The medication is also used to reduce the risk of cardiovascular death in adults with type 2 diabetes who have known cardiovascular disease.

“By extending the Jardiance label, physicians are now able to provide a diabetes medication that offers a life-saving cardiovascular benefit to type 2 diabetes patients with established cardiovascular diseases,” Professor Chee Kok Han said.

The National Pharmaceutical Regulatory Agency in Malaysia recently approved an update to the Jardiance (empagliflozin) label to include a change in the indication statement. Jardiance is indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus (T2D) to go along with diet and exercise. The approved product information now includes data on the reduction of cardiovascular death in patients with T2D and established CV disease in addition to data on the improvement of blood sugar control.

The update follows the product’s approval by the European Commission. Previously. Jardiance was also approved by the U.S. Food and Drug Administration on December 2nd, 2016.

The approval is based on results from the EMPA-REG OUTCOME trial, which showed that Jardiance reduced the risk of cardiovascular death by 38 % vs placebo when introduced to standard care. The trial also demonstrated that Jardiance significantly reduced the risk of the primary endpoint of CV death, non-fatal heart attack or non-fatal stroke by 14% versus placebo.