Studies show that even when treating to standards of care for type 2 diabetes (T2D) and cardiovascular disease (CVD), about 1 out of 6 patients may still experience an adverse CV event such as a heart attack or stroke.1
PEER PERSPECTIVES
Collaboration and the diabetes care team: Treating patients with T2D and established CVD
Watch as 4 health care professionals discuss a therapy that addresses both T2D and CV risk reduction, and how important collaboration is among the health care team to help patients reach their goals.
Select from the topics below to go directly to the video:
The team of diabetes experts

John E. Anderson, MD
INTERNIST

PROFESSIONAL ROLES
Private practice in Internal Medicine and Diabetes, The Frist Clinic
Former President, The Frist Clinic
Former President of Medicine & Science, ADA
MEMBERSHIPS
Member, Joint AHA/ACS/ADA
"Get with the Guidelines" Task Force
ACHIEVEMENTS
Winner of the Banting Medal for Scientific Achievement
LOCATION
Nashville, Tennessee

Helen L. Baron, MD
ENDOCRINOLOGIST

PROFESSIONAL ROLES
Assistant Professor of Clinical Medicine
University of Southern California (USC)
Chief Clinical Fellow, LAC + USC Endocrinology
Director of the Bone Mineral Density Unit, USC
Keck School of Medicine, Division of Endocrinology
USC Cardio–Thoracic (Heart & Lung) Transplant Team
Keck Hospital
HONORS
Speakers Bureau, American Diabetes Association
Greater Los Angeles Area, July 2013 - Present
LOCATION
Los Angeles, California

Ronald D’Agostino, DO, FACC, FACP
CARDIOLOGIST

PROFESSIONAL ROLES
Cardiologist, Long Island Cardiovascular Imaging and Consultants
Clinical Assistant Professor in the Department of Cardiology
Hofstra Northwell School of Medicine
HONORS
Fellow, American College of Physicians (FACP)
Fellow, American College of Cardiology (FACC)
LOCATION
Lake Success, New York

Melissa Magwire, RN, CDE
REGISTERED NURSE/CERTIFIED DIABETES EDUCATOR

PROFESSIONAL ROLES
Registered nurse, Shawnee Mission Physicians Group-Endocrinology & Diabetes Associates
MEMBERSHIPS
The American College of Cardiology:
Roundtable on Managing Cardiovascular Risk in Diabetes Planning Committee
American Association of Diabetes Educators
ACHIEVEMENTS
Chairperson/speaker, Taking Control of Your Diabetes National Conference
LOCATION
Shawnee, Kansas
VIDEO 1
Evolving treatment in diabetes to incorporate CV risk reduction

With [the] strong connection between type 2 diabetes and cardiovascular disease, it is increasingly important for diabetes therapies to have positive CVOT outcomes to address this CV risk.2

Ronald D’Agostino, DO, FACC, FACP
CARDIOLOGIST
Evolving treatment
- Wick A, Newlin K. Incretin-based therapies: therapeutic rationale and pharmacological promise for type 2 diabetes. J Am Acad Nurse Pract. 2009;21(suppl 1):623-630.
- Holst JJ, Vilsbøll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009;297(1-2):127-136.
- D'Alessio D. The role of dysregulated glucagon secretion in type 2 diabetes. Diabetes Obes Metab. 2011;13(suppl 1):126-132.
- Drucker DJ. The biology of incretin hormones. Cell Metab. 2006;3(3):153-165.
- Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368(9548):1696-1705.
- Nauck M, Stöckmann F, Ebert R, Creutzfeldt W. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1986;29(1):46-52.
- DeFronzo RA, Eldor R, Abdul-Ghani M. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. Diabetes Care. 2013;36(suppl 2):S127-S138.
- Zander M, Madsbad S, Madsen JL, Holst JJ. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and β-cell function in type 2 diabetes: a parallel-group study. Lancet. 2002;359(9309):824-830.
KEY TAKEAWAYS
- Treating patients with T2D is a collaborative effort that may involve a number of specialists
- The 2008 FDA mandate for all diabetes treatments to include CVOTs helped provide data solidifying the connection between T2D and CVD3
- It’s important to inform patients that additional CV risk may remain even when A1C is at goal4
- A medication is available for adults with T2D and established CVD that states in the label that it improves glycemic control and reduces the risk of MACE5
MACE= CV death, nonfatal MI, or nonfatal stroke


VIDEO 2
Diabetes treatment guidelines and addressing CV risk
Diabetes treatment guidelines
- Wick A, Newlin K. Incretin-based therapies: therapeutic rationale and pharmacological promise for type 2 diabetes. J Am Acad Nurse Pract. 2009;21(suppl 1):623-630.
- Holst JJ, Vilsbøll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009;297(1-2):127-136.
- D'Alessio D. The role of dysregulated glucagon secretion in type 2 diabetes. Diabetes Obes Metab. 2011;13(suppl 1):126-132.
- Drucker DJ. The biology of incretin hormones. Cell Metab. 2006;3(3):153-165.
- Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368(9548):1696-1705.
- Nauck M, Stöckmann F, Ebert R, Creutzfeldt W. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1986;29(1):46-52.
- DeFronzo RA, Eldor R, Abdul-Ghani M. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. Diabetes Care. 2013;36(suppl 2):S127-S138.
- Zander M, Madsbad S, Madsen JL, Holst JJ. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and β-cell function in type 2 diabetes: a parallel-group study. Lancet. 2002;359(9309):824-830.

Every health care professional who works with adults with type 2 diabetes has a slightly unique approach to treatment. That’s why guidelines from various organizations and associations are helpful, so that we can use evidenced-based research to make informed treatment decisions.


John E. Anderson, MD
INTERNIST
KEY TAKEAWAYS
- Before 2017, treatment guidelines for diabetes standards of care did not provide management algorithms that addressed CV risk in addition to glycemic control6
- With the results of the FDA-mandated CVOTs, ADA and AACE updated their guidelines to include information on treating patients with T2D that also address CV risk3,7
- Every health care professional who works with T2D has a slightly unique approach to treatment
- Sharing results from the LEADER trial with your patients may help when discussing Victoza®


VIDEO 3
Patient identification

For me, the exciting challenge of diabetes is understanding the disease process, knowing all of the different treatment options available, and not connecting the patient to the treatment until after I’ve had the chance to sit with them, and see who they are and what they need.

Helen L. Baron, MD
ENDOCRINOLOGIST
Patient identification
- Wick A, Newlin K. Incretin-based therapies: therapeutic rationale and pharmacological promise for type 2 diabetes. J Am Acad Nurse Pract. 2009;21(suppl 1):623-630.
- Holst JJ, Vilsbøll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009;297(1-2):127-136.
- D'Alessio D. The role of dysregulated glucagon secretion in type 2 diabetes. Diabetes Obes Metab. 2011;13(suppl 1):126-132.
- Drucker DJ. The biology of incretin hormones. Cell Metab. 2006;3(3):153-165.
- Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368(9548):1696-1705.
- Nauck M, Stöckmann F, Ebert R, Creutzfeldt W. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1986;29(1):46-52.
- DeFronzo RA, Eldor R, Abdul-Ghani M. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. Diabetes Care. 2013;36(suppl 2):S127-S138.
- Zander M, Madsbad S, Madsen JL, Holst JJ. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and β-cell function in type 2 diabetes: a parallel-group study. Lancet. 2002;359(9309):824-830.
KEY TAKEAWAYS
- With new data being released, treatment for adults with T2D is evolving
- For many health care providers, treating T2D and CVD go hand in hand2
- Not all GLP-1s are the same, and Victoza® is the only GLP-1 RA recommended by the ADA to lower CV event rates and mortality in adults with T2D and established CVD3
- If patients are concerned about starting an injectable treatment, consider using a sample and providing instructions right in the office


VIDEO 4
Collaboration and the diabetes care team
Collaboration
- Wick A, Newlin K. Incretin-based therapies: therapeutic rationale and pharmacological promise for type 2 diabetes. J Am Acad Nurse Pract. 2009;21(suppl 1):623-630.
- Holst JJ, Vilsbøll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009;297(1-2):127-136.
- D'Alessio D. The role of dysregulated glucagon secretion in type 2 diabetes. Diabetes Obes Metab. 2011;13(suppl 1):126-132.
- Drucker DJ. The biology of incretin hormones. Cell Metab. 2006;3(3):153-165.
- Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368(9548):1696-1705.
- Nauck M, Stöckmann F, Ebert R, Creutzfeldt W. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1986;29(1):46-52.
- DeFronzo RA, Eldor R, Abdul-Ghani M. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. Diabetes Care. 2013;36(suppl 2):S127-S138.
- Zander M, Madsbad S, Madsen JL, Holst JJ. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and β-cell function in type 2 diabetes: a parallel-group study. Lancet. 2002;359(9309):824-830.

With over 25 years of experience in the diabetes space, I know how important it is for these patients with type 2 diabetes to receive comprehensive care that may include a number of different specialists.


Melissa Magwire, RN, CDE
REGISTERED NURSE / CERTIFIED DIABETES EDUCATOR
KEY TAKEAWAYS
- Sometimes, it can take a “village” to care for patients with diabetes
- For some patients, the diabetes care team may include a cardiologist, nephrologist, endocrinologist, and more
- Educating patients may help facilitate the discussion between various specialists on the diabetes care team
- Regular communication with other specialists on the diabetes care team—through phone calls or quick discussions—may help when making treatment decisions


Change the course of treatment with Victoza® for your patients with T2D and established CVD
References:
- Shepherd J, Barter P, Carmena R, et al. Effect of lowering LDL cholesterol substantially below currently recommended levels in patients with coronary heart disease and diabetes. Diabetes Care. 2006;29:1220-1226.
- Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Clinical update: cardiovascular disease in diabetes mellitus. Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus-mechanisms, management, and clinical considerations. Circulation. 2016;133:2459-2502.
- American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;41(suppl 1):S1-S172.
- Fruchart J, Davignon J, Hermans MP, et al. Residual macrovascular risk in 2013: what have we learned? Cardiovasc Diabetol. 2014;13(26):2-17.
- Victoza [package insert]. Plainsboro, NJ: Novo Nordisk Inc; August 2017.
- American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care. 2017;40(suppl 1):S1-S135.
- Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm–2018 executive summary. Endocr Pract. 2018;24(1):91-120.
- Marso SP, Daniels GH, Brown-Frandsen K, et al; the LEADER Steering Committee on behalf of the LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311-322.