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Jan. 10, 2022 — Fewer than 1 in 5 people with type 2 diabetes in the United States meet targets to reduce heart disease risk, including a combination of lowering blood sugar, blood pressure, cholesterol, and eliminating smoking, the American Heart Association says.

That proportion drops to less than 1 in 10 if the person also has obesity, say Joshua J. Joseph, MD and colleagues in their paper, published in the journal Circulation.

“This new scientific statement is an urgent call to action to follow the latest evidence-based approaches … to advance type 2 diabetes treatment and care and reduce cardiovascular disease risk,” Joseph, assistant professor of medicine at the Ohio State University College of Medicine, and coauthors write.

The authors reviewed clinical trial evidence through June 2020 for lifestyle management of diabetes and weight, blood sugar targets and control, blood pressure management, cholesterol management, aspirin therapy, and screening for heart and kidney complications.

It also discusses the implications of recent large scale trials of newer blood sugar-lowering medications, which also help some heart and kidney issues.

The other 80% to 90% relate to social factors, such as health-related behaviors, income, educational levels attained, environmental factors, and racism.

“People with [type 2 diabetes] face numerous barriers to health including access to care and equitable care, which must be considered when developing individualized care plans with our patients,” Joseph said in the American Heart Association press release.

To improve on lifestyle, the authors say doctors should embrace “culturally appropriate recommendations,” giving people individualized advice on how to best self-manage their diabetes through a better understanding of the disease, and knowledge about healthy nutrition, to meet their own individualized goals.

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By Betty C. Giordano

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