One hundred internists from the Spanish Society of Internal Medicine (SEMI) have gathered at the scientific meeting “Diabetes and Heart Failure in the Cardiorenal Continuum” of the SEMI, in which they have discussed the main diagnostic and therapeutic novelties in the approach to heart failure and diabetes mellitusas well as on the main pathologies of the cardio-renal-metabolic sphere.
It’s about the second meeting meeting organized by the working groups of Diabetes, Obesity and Nutrition (DON) and Heart Failure and Atrial Fibrillation (ICyFA) of the SEMI. The meeting was attended by Juana Carretero, president of the SEMI, and the inaugural conference, under the title “Continuum cardio-renal of the patient with DM2”, which was in charge of Javier Carrasco Sánchez, from the Internal Medicine Service of the Juan Ramón Jiménez University Hospital in Huelva For their part, Pedro Pablo Casado and Jesús Casado, coordinators of the ICyFA and DON GT of SEMI, carried out the session “Highlights, conclusions and closure” of the day.
The main scientific novelties, as highlighted by Pedro Pablo Casado and Jesús Casado, are: “Updating in pharmacological strategies that allow Benefits in the cardio-renal-metabolic axis, the deepening of the mechanisms of action of drugs with a beneficial impact such as iSLGT2 and arGLP1, the analysis of the cardio-metabolic links and the importance of non-pharmacological aspects like the right one nutrition in these patients”.
Diabetes prevalence on the rise
As Pedro Pablo Casado recalls: “The prevalence of diabetes mellitus has increased by 30 percent worldwide in the past decade and HF affects 26 million people worldwide, with a prevalence that is also increasing. Both pathologies frequently coexist and the presence of one of them increases the chances of suffering from the other”.
In the same way, Jesús Casado emphasizes that “among patients with HF it is estimated that up to 47 percent also have diabetes mellitus, this percentage being higher among hospitalized patients. On the other hand, among patients with diabetes, the prevalence of HF is between 9 and 22 percent, which is four times more than the general population”.
During the meeting, it was reiterated that “the usual phenotype of patients with heart failure in the Internal Medicine Departments is that of an elderly patient, with a predominance of female sex, preserved ejection fraction, and heavy burden of comorbiditywith the i predominatingKidney failure, diabetes, obesity, atrial fibrillation, anemia, and COPD”.
The holistic nature of the Internal Medicine specialty and the broad spectrum of care (offices, hospitalization ward, interconsultants, etc.) makes it easier for internists be key specialists that can “assess a very diverse range of profiles of patients with diabetes, from recent diagnosis to highly evolved cases with a multitude of associated comorbidities, from people with full functionality to others with severe deterioration in their health status.” As Pedro Casado and Jesús Casado reiterate, what is unquestionable is that within this amalgamation, “there are many patients with diabetes that Internal Medicine sees who would benefit from the optimal treatment with the aim of improving the cardio-renal-metabolic axismain purpose of this meeting”.
Challenges in the approach to patients with diabetes and HF
Regarding the challenges in the approach to patients with diabetes and heart failurethroughout the meeting the following have been highlighted: “Improve prevention and early identification strategies, provide a global approach with key therapeutic targets in both pathologies, implement preventive strategies for renal deterioration that both pathologies cause and therapeutic optimization taking advantage of the current options that provide benefits in both entities.
Finally, the organizers of the meeting have coincided in emphasizing that “activities such as this one, which value not the diseases separately, but to the people who suffer from them as a wholeare the path to be followed by internists, in our obligation to offer a comprehensive patient care sick”.
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