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Management of Diabetes in Cardiovascular Diseases
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Management of Diabetes in Cardiovascular Diseases

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

Deadline for manuscript submissions: closed (20 August 2024) | Viewed by 4538

Special Issue Editor

Dr. Juan José Gorgojo-Martínez

E-Mail Website
Guest Editor
Head of Department. Department of Endocrinology and Nutrition, Hospital Universitario Fundacion Alcorcon, Alcorcon, 28922 Madrid, Spain
Interests: type 2 diabetes; obesity; metabolic surgery; precision diabetology

Special Issue Information

Dear Colleagues,

We cordially invite you to participate as an author in this Special Issue of JCM on “Management of Diabetes in Cardiovascular Diseases”.

Multiple cardiovascular (CV) risk factors, such as hypertension, dyslipidemia, obesity and inflammation, often coexist in individuals with type 2 diabetes (T2DM). Atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) are leading causes of morbidity and mortality for these patients. Intensive glycemic control reduces the microvascular complications of T2DM, but it does not provide a clear beneficial effect on ASCVD or HF. In recent years, several glucose-lowering drugs (GLDs) from two therapeutic families, GLP-1 receptor agonists and sodium-glucose co-transporter type 2 inhibitors, have shown a reduction in CV and renal morbidity and mortality in patients with T2DM and CV disease. A comprehensive approach to CV reduction in T2DM should include these GLDs, irrespective of the glycemic control or metformin use, and at the same level as other drugs with CV or renal protection, such as statins, PCSK-9 inhibitors, bempedoic acid, icosapent ethyl, ezetimibe, acetylsalicylic acid, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers or finerenone. Other important elements of the multifactorial intensification of therapy in patients with T2DM and CV disease include a healthy lifestyle, weight loss in overweight patients, and deprescription of those drugs without CV benefit and, in some cases, metabolic surgery.

In summary, we have multiple tools to change the natural history of patients with T2DM and ASCVD or HF at present. We look forward to receiving your submissions to this Special Issue.

Dr. Juan José Gorgojo-Martínez
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

  • type 2 diabetes
  • cardiovascular disease
  • lifestyle
  • SGLT-2 inhibitors
  • GLP-1 receptor agonists
  • weight-loss drugs
  • metabolic surgery.

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Published Papers (2 papers)

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Research

21 pages, 2231 KiB  
Article
Differential Ophthalmological Profile in Patients with Coronary Artery Disease Coexisting with Type 2 Diabetes Mellitus: Elevated Tear Cytokine Concentrations
by Rafael Jiménez-López, José Lorenzo Romero-Trevejo, Lourdes Fernández-Romero, Laura Martín-Chaves, Miguel Romero-Cuevas, Ana Isabel Molina-Ramos, María José Sánchez-Quintero, Mora Murri, Francesco Costa, Vicente Bodí, Mario Gutiérrez-Bedmar, Jorge Rodríguez-Capitán, Francisco Javier Pavón-Morón and Manuel Jiménez-Navarro
J. Clin. Med. 2024, 13(16), 4906; https://doi.org/10.3390/jcm13164906 - 20 Aug 2024
Viewed by 1165
Abstract
Background/Objectives: Coronary artery disease (CAD) and type-2 diabetes mellitus (T2DM) are characterized by chronic low-grade inflammation. However, measuring cytokines typically involves invasive blood sampling, which can be problematic for CAD patients. This study aimed to assess ophthalmological parameters and tear cytokines in [...] Read more.
Background/Objectives: Coronary artery disease (CAD) and type-2 diabetes mellitus (T2DM) are characterized by chronic low-grade inflammation. However, measuring cytokines typically involves invasive blood sampling, which can be problematic for CAD patients. This study aimed to assess ophthalmological parameters and tear cytokines in patients with CAD, comparing those with comorbid T2DM to those without to understand their inflammatory profiles. Methods: One hundred subjects with suspected chronic or acute CAD were initially included in this single-center cross-sectional study after clinical stabilization. Seventy-two patients with confirmed CAD were divided into two groups: 32 patients with T2DM and 40 patients without T2DM. A total of 144 eyes were examined, and tear fluid samples were collected to determine cytokine concentrations. Ophthalmological parameters and tear concentrations of cytokines were analyzed, controlling for age, sex, and other cardiovascular risk factors. Results: Patients with CAD and T2DM exhibited decreased ophthalmological parameters and increased cytokine concentrations in comparison to those without T2DM. Significant inverse correlations between ophthalmological parameters and cytokine concentrations were observed. Following adjustment, a full logistic regression model for distinguishing patients with CAD and comorbid T2DM included macular cube volume, mean macular thickness, interleukin (IL)-4, IL-5, IL-6, IL-8, IL-9, IL-13, granulocyte colony-stimulating factor (G-CSF), CCL3, CCL4, and CCL11/eotaxin-1, demonstrating excellent discriminatory power (Area Under the Curve = 0.95, 95% Confidence Interval = 0.91–0.99; p < 0.001). Subsequently, IL-5 (Odds Ratio = 1.68, 95% CI = 1.26–2.24; p < 0.001), G-CSF (OR = 1.06, 95% CI = 1.02–1.11; p < 0.01), and CCL11/eotaxin-1 (OR = 1.56, 95% CI = 1.19–2.05; p = 0.001) emerged as the most distinguishing variables in a reduced model (AUC = 0.89, 95% CI = 0.84–0.95; p < 0.001). Conclusions: Differences in ophthalmological variables, mainly in cytokine concentrations, suggest distinct pathophysiological mechanisms in patients with CAD based on the presence of T2DM. These findings demonstrate that the inflammatory profile can be readily detected through tear sample cytokines, proving valuable for establishing more accurate prognoses and monitoring in cardiometabolic disorders. Full article
(This article belongs to the Special Issue Management of Diabetes in Cardiovascular Diseases)
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14 pages, 815 KiB  
Article
Effectiveness and Tolerability of the Intensification of Canagliflozin Dose from 100 mg to 300 mg Daily in Patients with Type 2 Diabetes in Real Life: The INTENSIFY Study
by Juan J. Gorgojo-Martinez, Pablo José Ferreira-Ocampo, Alba Galdón Sanz-Pastor, Jersy Cárdenas-Salas, Teresa Antón-Bravo, Miguel Brito-Sanfiel and Francisca Almodóvar-Ruiz
J. Clin. Med. 2023, 12(13), 4248; https://doi.org/10.3390/jcm12134248 - 25 Jun 2023
Cited by 5 | Viewed by 2822
Abstract
Aim: This study aimed to evaluate the effectiveness and tolerability of intensifying the dose of canagliflozin from 100 mg/day (CANA100) to 300 mg/day (CANA300) in patients with type 2 diabetes (T2DM) and suboptimal metabolic control in a real-world setting. Methods: A multicenter observational [...] Read more.
Aim: This study aimed to evaluate the effectiveness and tolerability of intensifying the dose of canagliflozin from 100 mg/day (CANA100) to 300 mg/day (CANA300) in patients with type 2 diabetes (T2DM) and suboptimal metabolic control in a real-world setting. Methods: A multicenter observational study was conducted on adult patients with T2DM who initiated treatment with CANA100 and subsequently required intensification to CANA300. The primary outcome measures were changes in HbA1c and weight at 6 months after the switch and at the end of the follow-up period. Results: A total of 317 patients met the inclusion criteria (59.6% male, mean age 62.2 years, baseline HbA1c 7.55%, weight 88.6 kg, median duration of treatment with CANA100 9.9 months). Switching to CANA300 resulted in a significant reduction in HbA1c (6 months: −0.33%; last visit: −0.47%, both p < 0.0001) and weight (6 months: −1.8 kg; last visit: −2.9 kg, both p < 0.0001) over a median follow-up period of 20.8 months. The proportion of patients that achieved HbA1c < 7% increased from 26.7% with CANA100 to 51.6% with CANA300 (p < 0.0001). Among individuals with poor baseline glycemic control (HbA1c > 8%, mean 9.0%), HbA1c was significantly reduced by −1.24% (p < 0.0001). Furthermore, significant improvements were observed in fasting plasma glucose (FPG), blood pressure (BP), liver enzymes, and albuminuria. No unexpected adverse events were reported. Conclusions: Intensifying the treatment to CANA300 in a real-world setting resulted in further significant and clinically relevant reductions in FPG, HbA1c, weight, and BP in patients with T2DM. The switch was particularly effective in patients with higher baseline HbA1c levels. Full article
(This article belongs to the Special Issue Management of Diabetes in Cardiovascular Diseases)
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