Multifactorial aspects in diabetes management: new perspectives

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Multifactorial aspects in diabetes management: new perspectives

by Ioannis Ioannou, Professor of Internal Medicine, Diabetes and Metabolic Diseases, Clinical Tutor, University of Nicosia Medical School.

Introduction by Petros Karayiannis, Professor of Microbiology/Molecular Virology, University of Nicosia Medical School.

According to the International Diabetes Federation, the global incidence of Diabetes for 2019 was 463 million. It is estimated that by 2040 there will be over 600 million diabetics in the world.

Type2 Diabetes (T2D) is generally regarded as a disease due to rising levels of obesity, physical inactivity and poor diet. Diabetes is associated with many complications including coronary heart disease, heart failure, peripheral artery disease, stroke, retinopathy, neuropathy, and nephropathy.

Cardiovascular disease is the primary complication of diabetes: approximately 65% of diabetic deaths are contributed to heart disease and stroke. Cardiovascular risk reduction requires control of multiple factors such as HbA1c, LDL, BP. micro albuminuria, and smoking. The multifactorial approach is essential for the treatment of diabetes. Glycaemic management is only one component of the multifactorial approach that has been shown to reduce diabetes complications, but effective glucose control often requires the prescription of agents that can in turn provide cardio renal protection. Selective pharmacologic therapy for patients with T2D depends on the presence of risk factors such as comorbid heart failure, atherosclerotic disease and renal disease.

There is increasing evidence that the combination of SGLT2i and GLP1 receptor agonists is associated with reduced odds for major adverse cardiac events, renal and weight loss benefits and reduction of blood pressure.


Professor of Internal Medicine, Diabetes and Metabolic Diseases Ioannis Ioannou is a Clinical Tutor at the University of Nicosia Medical School. He received his Doctor of Medicine degree (MD) from the National and Kapodistrian University of Athens with his thesis topic on Diabetic Neuropathy. In 1989 Prof Ioannou received a specialization in Internal Medicine from the University Clinic of Internal Medicine at Evangelismos Hospital in Athens, Greece and in 1991 he obtained a second specialization in Diabetology from the same hospital.

Professor Ioannou is currently practising medicine at Ygia Polyclinic in Limassol.

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