Monday, July 10, 2006

GSK and CVS Diabetology

In an effort to emphasize the importance of CVS complications in diabetes, GSK, the maker of Rosiglitazone (Avandia), invited us to attend one of their CME for their key opinion leaders in the Asia-Pacific region, held in Singapore. The program was relatively light but it gave us an opportunity to highlight the fact that patients with diabetes, do not die from diabetes per se, but from complications of the heart and cardiovascular system, something we call macrovascular and microvascular complications.

As we have reported earlier, patients with diabetes, has a CVS age about 15 years older. That patients with diabetes, has an increased CVS risk althought their resting BP is 120/80 mm Hg. Also that a diabetic at 49 years old, has the same longterm prognosis as a non-Diabetic with an initial heart attack. We were also told that 25% of Malaysians suffer from T2 DM (type 2 Diabetes Mellitus). Even worse, that the majority are poorly controlled.

Obviously, worldwide, and also in Malaysia, obesity is increasing and so is diabetes. I actually asked the experts, what they think the country should do to reduce the incidence of T2DM. I suppose, we should all walk more and eat less, carbs and sugars especially. I am in favour of labelling all food substances for their ingredients, so that we all know how many calories we are taking in. Even more important, we must reduce the amount of sugars in soft drinks so that the younger generation can be protected from obesity. It will be good if we all can know our BMI and also our waistline, thereby allowing us to be more health conscious. Yes diabetes is a CVS disease, I am convinced. Even more important, that we also understand that the father or uncle of diabetes is obesity. Obesity, hypetension, diabetes are all part of a cardiovascular continumm, that results in micro and macrovascular disease, heart attacks, peripheral vascular disease, strokes, retinopathy and nephropathy. Please eat healthily and exercise regularly.

1 comment:

Jan said...

I just did a stress test today on a 42 year old who had CABG at 35.
He has been a type I diabetic since he was 20. Even adding the 15 years to make him cardiovascularly 50 when he had his surgery, he would still be considered to have premature CAD.

Did GSK say anything about creating at TZD drug that does not contribute to volume overload and CHF? Many patients with heart failure cannot be on metformin due to renal insufficiency, also have had several pts have CHF precipitated by Avandia and related drugs.
Unfortunately these patients then end up on higher and higher doses of insulin resulting in more weight gain and the cycle goes on.