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New Insights into Diabetes and Cardiovascular Diseases
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New Insights into Diabetes and Cardiovascular Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (10 October 2025) | Viewed by 5559

Special Issue Editor

Dr. Simona Giubilato

E-Mail Website
Guest Editor
Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy
Interests: coronary artery disease; cardiovascular intensive care; anthitrombotic therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last decade, there has been remarkable progress in our understanding of the molecular and pathophysiological mechanisms linking diabetes to cardiovascular diseases. Furthermore, recent years have seen the discovery of new pharmacological approaches that not only address hyperglycemia but also offer significant cardiovascular benefits.

In particular, the emergence of SGLT2 inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP-1as) has revolutionized the management of diabetic patients with cardiovascular diseases. These therapies have demonstrated improved outcomes in both atherosclerotic cardiovascular diseases and heart failure, marking a significant shift in therapeutic strategies and patient care.

For this Special Issue, we welcome contributions from researchers and clinicians to explore the latest findings in this critical area. We encourage the submission of original research, reviews, and clinical studies that delve into the mechanisms by which diabetes exacerbates cardiovascular disease, the impact of emerging therapies, and the potential for these innovations to improve prognosis.

We look forward to your valuable contributions to this Special Issue, which aims to shape the future of diabetes and cardiovascular disease management.

Dr. Simona Giubilato
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diabetes
  • cardiovascular diseases
  • heart failure
  • pharmacological approaches
  • SGLT2 inhibitors
  • GLP-1 receptor agonists

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Related Special Issue

Published Papers (4 papers)

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Research

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11 pages, 233 KB  
Article
Impact of Ertugliflozin on Cardiac Structure and Function in Patients with ICDs/CRT-Ds Assessed by Echocardiography: A Post Hoc Sub-Analysis of the ERASe Trial
by Viktoria Santner, Ewald Kolesnik, Martin Benedikt, Abderrahim Oulhaj, Ursula Rohrer, Martin Manninger, Norbert J. Tripolt, Peter N. Pferschy, Faisal Aziz, Markus Wallner, Nora Schwegel, Nicolas Verheyen, Klemens Ablasser, Johannes Gollmer, Marianne Gwechenberger, Martin Martinek, Michael Nürnberg, Clemens Steinwender, Andreas Zirlik, Markus Stühlinger, Harald Sourij, Dirk von Lewinski and Daniel Scherradd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(23), 8294; https://doi.org/10.3390/jcm14238294 (registering DOI) - 22 Nov 2025
Abstract
Background/Objectives: Ertugliflozin showed a beneficial effect to reduce arrhythmic burden in heart failure patients with an ejection fraction less than 50% with an implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy device (CRT-D) in the ERASe trial. The aim of the [...] Read more.
Background/Objectives: Ertugliflozin showed a beneficial effect to reduce arrhythmic burden in heart failure patients with an ejection fraction less than 50% with an implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy device (CRT-D) in the ERASe trial. The aim of the post hoc sub-analysis of the ERASe trial was to compare the effect of ertugliflozin versus placebo on structural and functional parameters assessed by echocardiography. Methods: In this sub-analysis of the ERASe trial, 40 patients (87% of the overall ERASe trial cohort) with stored echocardiography loops and adequate image quality were included. A post hoc analysis including structural and functional echocardiography parameters was performed by a trained investigator blinded to the treatment group. Results: After 52 weeks of treatment, there were no between-group differences in left and right ventricular dimensions (left ventricular end-diastolic and -systolic volumes, right ventricular diameter) and function (left ventricular ejection fraction [LVEF], tricuspid annular plane systolic excursion), after adjustment for baseline values. Lower LVEF at baseline was associated with a higher number of ventricular arrhythmias in both treatment groups. Conclusions: In this sub-analysis of the ERASe trial, treatment with ertugliflozin did not improve structural and functional parameters assessed by echocardiography after 52 weeks of treatment compared to placebo despite the significant reduction in arrhythmic burden. Full article
(This article belongs to the Special Issue New Insights into Diabetes and Cardiovascular Diseases)
10 pages, 776 KB  
Article
Diabetes Is Associated with Lower In-Hospital Mortality in Patients Undergoing Surgical Repair for Aortic Aneurysm Rupture
by Hamza Chaudhry, Soha Dargham, Ziyad Mahfoud, Amin Jayyousi, Jassim Al Suwaidi and Charbel Abi Khalil
J. Clin. Med. 2025, 14(12), 4370; https://doi.org/10.3390/jcm14124370 - 19 Jun 2025
Viewed by 761
Abstract
Background: Previous studies reported a protective effect of type 2 diabetes on the progression of aortic aneurysms. We aimed to investigate whether this paradoxical phenomenon remained in patients with diabetes undergoing repair of ruptured aortic aneurysms. Methods: Data from the US [...] Read more.
Background: Previous studies reported a protective effect of type 2 diabetes on the progression of aortic aneurysms. We aimed to investigate whether this paradoxical phenomenon remained in patients with diabetes undergoing repair of ruptured aortic aneurysms. Methods: Data from the US Nationwide Readmission Database from 2016 to 2019 were analyzed. Patients admitted for surgical repair of ruptured abdominal or thoracic aortic aneurysms were included. Patients discharged alive were followed for 30 days. The co-primary outcomes were in-hospital and 30-day mortality. Results: A total of 9858 patients hospitalized for surgical repair of ruptured abdominal or thoracic aortic aneurysm were included, of whom 16.4% had diabetes. A lower adjusted risk of in-hospital mortality in abdominal and thoracic aneurysms was observed in diabetes patients (aOR = 0.76 [0.67–0.87], 0.61 [0.46–0.810], respectively). However, atrial fibrillation and acute renal failure were more likely to occur in the presence of diabetes (aOR = 1.25 [1.11–1.42]; 1.17 [1.05–1.32], respectively). Within 30 days, diabetes was not associated with a difference in the incidence of mortality or readmission (aHR = 1.47 [95% CI 0.98–2.22]; 1.15 [95% CI 0.99–1.34], respectively). Cardiovascular system-related pathologies were the most prevalent etiologies in all readmitted patients. Infections were more likely to occur in the diabetes group (16.0% vs. 11.0%, respectively, p = 0.042). Conclusions: The paradoxical effect of diabetes is also observed in ruptured aneurysms treated surgically, as type 2 diabetes patients have a lower in-hospital mortality. However, this protective effect does not extend to 30-day readmission or survival. Full article
(This article belongs to the Special Issue New Insights into Diabetes and Cardiovascular Diseases)
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21 pages, 2291 KB  
Article
Active Detection of Glucose Metabolism Disorders Prior to Coronary Artery Bypass Grafting: Associations with In-Hospital Postoperative Complications
by Alexey N. Sumin, Natalia A. Bezdenezhnykh, Ekaterina. V. Belik, Andrew V. Bezdenezhnykh, Olga V. Gruzdeva and Olga L. Barbarash
J. Clin. Med. 2025, 14(9), 3123; https://doi.org/10.3390/jcm14093123 - 30 Apr 2025
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Abstract
Background/Objectives: Patients with coronary artery disease undergoing coronary artery bypass grafting (CABG) have a high prevalence of type 2 diabetes mellitus (T2DM) and prediabetes. Glucose metabolism disorders (GMDs) are often asymptomatic and remain undetected, but untreated they can have adverse effects. To evaluate [...] Read more.
Background/Objectives: Patients with coronary artery disease undergoing coronary artery bypass grafting (CABG) have a high prevalence of type 2 diabetes mellitus (T2DM) and prediabetes. Glucose metabolism disorders (GMDs) are often asymptomatic and remain undetected, but untreated they can have adverse effects. To evaluate the possibilities of active screening in identifying T2DM and prediabetes before CABG and to assess the impact of GMD on the incidence of postoperative complications. Methods: This study included 1021 patients who underwent CABG in 2016–2018 at the department of cardiovascular surgery, whose glycemic status was determined. All patients had their glycated hemoglobin (HbA1c) levels measured; those without a previous diagnosis of diabetes underwent an oral glucose tolerance test. The frequency of newly diagnosed diabetes and prediabetes was evaluated. Postoperative complication rates were analyzed among patient groups with various types of GMDs and normal blood glucose levels. Results: Screening before CABG increased the number of patients with established type 2 diabetes from 20.9 to 27.8% and the number of people with prediabetes from 2.7% to 31.7%. When analyzing hospital complications, patients with type 2 diabetes compared to patients with normoglycemia were significantly more likely to develop heart failure (p = 0.010), multiple organ failure (p = 0.002), require extracorporeal homeostasis correction (p = 0.011), and wound dehiscence (p = 0.004). Nine patients (0.9%) died following CABG without being discharged from the hospital, with 90% of these deaths occurring in patients with GMDs. Any GMD (diabetes or prediabetes) was associated with an increased incidence of postoperative heart failure (OR 1.259; p = 0.011), rhythm disturbances (OR 1.236; p = 0.010), major cardiovascular complications and/or heart failure (OR 1.193; p = 0.039), and all cardiovascular complications (OR 1.455; p = 0.002). In the presence of any GMD, the risk of multiple organ failure increased by 2.5 times (OR 2.506; p = 0.014), extracorporeal correction of homeostasis increased by 1.8 times (OR 1.821; p = 0.034), and diastasis of the wound edges increased by 1.3 times (OR 1.266; p = 0.005). It is important that, when adjusting for gender and age, the effect of GMD on the described complications remained significant. Conclusions: Active preoperative detection established an extremely high prevalence of GMD in patients with multivessel coronary artery disease (59.5%). T2DM and prediabetes are significant predictors of postoperative complications of coronary artery bypass grafting. Full article
(This article belongs to the Special Issue New Insights into Diabetes and Cardiovascular Diseases)
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Review

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23 pages, 2144 KB  
Review
GLP-1 Agonists in Cardiovascular Diseases: Mechanisms, Clinical Evidence, and Emerging Therapies
by Han-Mo Yang
J. Clin. Med. 2025, 14(19), 6758; https://doi.org/10.3390/jcm14196758 - 24 Sep 2025
Viewed by 3504
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists now serve as therapeutic agents for cardiovascular diseases (CVDs) beyond their original use for treating type 2 diabetes mellitus (T2DM). This review combines molecular mechanisms with clinical evidence to demonstrate how GLP-1 agonists help lower cardiovascular risk for [...] Read more.
Glucagon-like peptide-1 (GLP-1) receptor agonists now serve as therapeutic agents for cardiovascular diseases (CVDs) beyond their original use for treating type 2 diabetes mellitus (T2DM). This review combines molecular mechanisms with clinical evidence to demonstrate how GLP-1 agonists help lower cardiovascular risk for conditions, including atherosclerosis, heart failure, stroke, and vascular dementia. These agents produce multiple beneficial effects, which include anti-inflammatory action along with anti-atherogenic effects, endothelial-protective benefits, and cardioprotective actions to minimize major adverse cardiovascular events (MACEs). GLP-1 agonists achieved substantial reductions in myocardial infarction, stroke, cardiovascular mortality, and heart failure events according to major cardiovascular outcome trials (CVOTs). Recent research, notably the pivotal SELECT trial, has confirmed their suitability for non-diabetic subjects with obesity and established CVD. New drug delivery methods and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists demonstrate potent efficacy, with tirzepatide showing significant MACE reduction in its own CVOT. However, significant challenges related to high cost, long-term safety uncertainties, and implementation barriers remain, requiring a balanced perspective. The review presents both mechanistic data and clinical evidence to demonstrate how GLP-1 agonists function as vital cardiovascular medications and outlines future research directions to address critical evidence gaps and maximize their therapeutic effectiveness. Full article
(This article belongs to the Special Issue New Insights into Diabetes and Cardiovascular Diseases)
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