Diabetes Cardiorenal & Metabolism Institute Share New Care Recommendations

The Diabetes, CardioRenal Metabolic Diseases (DCRM) Task Force has published new recommendations for the management of patients with an array of diseases and risk factors in this multi-specialty complex.

The recommendations, simultaneously presented at the World Congress on Insulin Resistances, Diabetes & Cardiovascular Disease (WCIRDC) 2021 meeting in Los Angeles and published in the Journal of Diabetes and Its Complications on Friday evening, provide what DCRM Task Force chair and WCIRDC program director Yehuda Handelsman, MD, called a first-of-its-kind practice advisory for patients with overlapping diabetic, cardiorenal and metabolic disease.

“This unique initiative incorporated multiple specialties: Cardiology, Endocrinology, Primary Care, and Nephrology in developing recommendations addressing the whole patient,” Handelsman said in a statement. “These clinical recommendations will target the specialists and Primary Care clinicians alike, with focus on the non-experts, making the recommendations clinically relevant and simple to implement.”

Modern cardiovascular outcome trial results already reach across multiple disciplines, Yehuda said. “As such, no single medical society is truly capable of developing a multifaceted comprehensive guidance,” he argued. Rather, the 31-member DCRM task force boasts representation of numerous major medical societies:

• American Association of Clinical Endocrinology (AACE)
• American College of Cardiology (ACC)
• American Diabetes Association (ADA)
• American Heart Association (AHA)
• Heart Failure Society of America (HFSA)
• Kidney Disease: Improving Global Outcomes (KDIGO)

In an interview with HCPLive during WCIRDC 2021, DCRM Task Force member Matthew Budoff, MD, discussed his involvement in establishing some of the recommendations—namely, early detection of end-organ damage; the use of new, targeted therapies; and appropriate treatment of patients with diabetes and atherosclerotic cardiovascular disease (ASCVD).

“(It’s about) making sure we get those patients on those therapies that have the biggest benefit—so when appropriate, SGLT-2 inhibitors, GLP-1 receptor agonists, things like rivaroxaban, PCSK9 inhibitors, and other newer therapies that are important to keep in mind when we have patients with high-risk state,” he explained.

Budoff credited Handelsman for not only recruiting experts from differing specialties to represent the task force, but targeting specialists with expertise in specific diseases.

“For example, in cardiology, we have heart failure experts, atherosclerosis experts, we have lipid management experts, to really help us focus in on the divergent information that’s available and come up with the most cogent cross-specialty recommendations that we could,” he explained.

The goals of the recommendations are to facilitate improved understanding and adoption of best practices in each of these specialties, with the guidance being informed by leading societies, Budoff said.

“The big win will be as it trickles down to the physicians who treat patients on a day-to-day basis—them having a practical guideline rather than having to refer to 4 different guidelines and trying to merge the data to figure out what the next best step would be,” he said.

The DCRM Task Force recommendations are available to read here.