ESC 2024: How diabetologists and cardiologists are paving the way for precision medicine

Cardiologists are increasingly interested in advances in diabetology, especially the latest drug classes, reports Tina Vilsbøll from a joint session of the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) at this year’s ESC Congress. She advocates for a multidisciplinary approach, with the patient at the centre of care.

To kick off the autumn conference season, London hosted the ESC Congress, the world’s largest cardiology meeting, with over 30,000 participants. Among the many discussions, the intersection of cardiology and diabetology, particularly the use of modern glucose-lowering drugs such as SGLT2 inhibitors and GLP-1 based therapies, took centre stage.

“Cardiology and diabetology used to be separate disciplines, but now they’re merging, discussing the same peptides and the same patients,” says Tina Vilsbøll, Honorary Secretary of the EASD and speaker at the EASD/ESC Joint Symposium. This marks a shift that began with the presentation of the EMPA-REG OUTCOME trial and is now reflected in the ADA/EASD guidelines, which prioritise comorbidities rather than glucose levels. The message is clear: Precision medicine is here to stay. Vilsbøll highlights the importance of individualised therapies that consider comorbidities, body weight and personal circumstances.

When is the best time to initiate treatment?

One of the main challenges of the multidisciplinary approach is determining when to start treatment. “For patients who are admitted with acute complications, the temptation is high to give several drugs right away,” says Vilsbøll. However, she stresses that more research is needed to determine whether treatment should be started in hospital or gradually in an out-patient setting. Structured follow-up plans are also a necessity for effective long-term treatment, Vilsbøll agrees with Julia Mader, who also spoke at the joint session.

Remission does not eliminate the risk

In addition, after entering the disease management phase, precision medicine must take a holistic approach, moving away from the gluco-centric view that has long dominated diabetology, says Vilsbøll. “Even when HbA1c-levels reach remission, these people remain high-risk individuals,” she warns. Nevertheless, Vilsbøll is optimistic about the potential of multidisciplinary collaboration and modern medicines: “Together, we can finally change the fate of people with diabetes.”

To learn more about the ESC, go to: https://www.escardio.org/

Author: Hanna Gabriel, BA MSc. Any opinions expressed in this article are the responsibility of EASD e-Learning.