February is American Heart Month: an annual celebration that began in 1963 to encourage Americans to join the battle against heart disease, a public health epidemic that has continued to grow in the past few decades. As cardiovascular disease has become the leading cause of death for both men and women in the United States, this month is an optimal opportunity to recommit yourself to a healthy lifestyle—and continue to make incremental changes to lead to a lifetime of heart health.
Type 2 diabetes mellitus (T2DM) is associated with multiple comorbidities, including cardiovascular disease (CVD), hypertension, obesity, dyslipidemia and kidney disease: all of which increase its morbidity and mortality, and complicate treatment decisions.1 Death from CV disease (CVD) is 70% higher in adults with diabetes—compared to those without diabetes—and patients with diabetes have a decreased life expectancy, mostly due to premature CV death. The recent and continuously emerging results from cardiovascular outcomes trials (CVOTs) with newer antihyperglycemic drugs have shown not only cardiovascular safety, but also CV benefits in addition to non-CV (renal, blood pressure, weight loss) beneficial effects, and are poised to change the clinical management of T2DM and its comorbidities.2 As such, guidelines to individualize T2DM therapy based on patients’ comorbidities have already been updated to reflect the results from these landmark randomized clinical trials (RCTs).2
Originally published in Annals of Internal Medicine and later reported in Medscape Medical News, a recent large database study confirmed that SGLT-2 inhibitor canagliflozin does not appear to raise fracture risk among patients with type 2 diabetes—confirming the importance of real-world studies in diabetes management.
AHA/ACC publishes new guidelines on the management of atrial fibrillation
The American College of Cardiology and American Heart Association have published a joint report focused on updated guidelines for the management of patients with atrial fibrillation, with the purpose of updating the 2014 guidelines in areas for which new evidence has emerged. The focused update includes revisions to “the section on anticoagulation…catheter ablation of atrial fibrillation (AF)…the management of AF complicating acute coronary syndrome (ACS), and new sections on device detection of AF and weight loss.” 
American Diabetes Association releases 2019 standards of care
The American Diabetes Association has released its Standards of Medical Care in Diabetes—2019: including all of the organization’s current clinical practice recommendations, designed to provide clinicians, patients, researchers, and others with comprehensive guidelines and recommendations surrounding “diabetes education, general treatment goals, and tools to evaluate the quality of care.” The Standards of Care is updated by the ADA annually, in an effort to continue to deliver the most current and authoritative guidelines for diabetes care. In order to perform the update, the ADA’s Professional Practice Committee performs an extensive literal search, with supplementary input from the medical community.
AHA position statement on statin safety and adverse events
The American Heart Association has issued a scientific statement regarding statin safety and associated adverse events, providing an examination of statins and their tolerability—and reviewing potential negative effects. The statement not only evaluates randomized controlled trials and subsequent meta-analyses, but also pinpoints possible correlations between statin therapy and a modestly increased risk of diabetes development—in addition to hemorrhagic stroke. However, in patients for whom current guidelines recommend statin therapy & treatment, the benefits greatly outweigh any negative, adverse effects, or safety concerns.   
FDA panel split on sotagliflozin for type 1 diabetes
The US Food and Drug Administration is split on whether or not the benefits of sotagliflozin—a dual SGLT1 and SGLT2 inhibitor—outweigh the risks in the treatment of type 1 diabetes, as an adjunct to insulin. Delivering a tie vote, the FDA’s Endocrinologic and Metabolic Drugs Advisory Committee’s vote was 8 to 8. While panel members agreed about both the benefits & risks of the drug in patients with type 1 diabetes, the risk for diabetic ketoacidosis with sotagliflozin was significantly higher in patients who received it, compared to placebo.
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