During a Sunday afternoon symposium, four experts will examine the effects of diabetes prevention efforts on diabetes complications and related conditions, including macrovascular disease, microvascular disease, cancer, cognitive decline, and physical impairment. The two-hour symposium, which begins at 4:30 p.m. in room W415B (Valencia Ballroom), is titled Diabetes Prevention—What Are We Preventing?
Jean-Louis Chiasson, MD, Professor of Medicine at the University of Montréal, Canada, will review eight clinical trials that reach all the way back to the 1960s and try to reconcile what on the surface may appear to be conflicting results with regard to cardiovascular (CV) outcomes and diabetes prevention.
The older studies that Dr. Chiasson will review suggest that treating dysglycemia for more than 20 years reduces cardiovascular disease, he said, while the more recent studies have yielded negative results relating to CV events. Dr. Chiasson will propose that most dysglycemia treatments act through the same molecular pathways as the treatment of other CV risk factors, so it’s more difficult to observe an effect of glycemic interventions above the treatment of other CV risk factors.
“It would explain why more recent studies in much larger populations have not been able to confirm those older studies,” Dr. Chiasson said. “Therefore, we still need well-designed, well-powered randomized control trials over prolonged follow-up periods to confirm the effects of treating dysglycemia on cardiovascular disease in patients with prediabetes.”
Jill P. Crandall, MD, Chief of the Division of Endocrinology at Albert Einstein College of Medicine, will examine the links between diabetes and prediabetes with nontraditional diabetes complications such as increased rates of cancer, physical function decline, cognitive impairment, and Alzheimer’s disease. She will also discuss how diabetes prevention efforts—particularly lifestyle modification and metformin—have the potential to improve these conditions.
Diabetes is associated with a broader range of complications and associated conditions than is typically appreciated, noted Dr. Crandall, who said diabetes interventions should be evaluated for their effect on these additional conditions.
“As the population with diabetes ages, these conditions become more prevalent and have a huge impact on quality of life,” Dr. Crandall said. “We also need to consider the broader impact of dysglycemia on the risk of other diseases.”
Also during the session, Leigh Perreault, MD, Associate Professor of Medicine at the University of Colorado Anschutz Medical Campus, will present a rationale for proactively treating the 84.1 million Americans with prediabetes.
“We have much more control of preventing diabetes and other micro- and macrovascular complications if we proactively treat people with prediabetes,” Dr. Perreault said.
The session’s other presenter, Lena Carlsson Ekander, MD, PhD, Professor in the Department of Molecular and Clinical Medicine at the University of Gothenburg, Sweden, will discuss microvascular disease prevention.