Mechanism-driven therapy for diabetic cardiovascular disease

Fabian Sanchis-Gomar , Carl J. Lavie , Salvatore Carbone , Ian J. Neeland

Metabolism and Target Organ Damage ›› 2026, Vol. 6 ›› Issue (2) : 31

PDF
Metabolism and Target Organ Damage ›› 2026, Vol. 6 ›› Issue (2) :31 DOI: 10.20517/mtod.2026.84
Commentary
Mechanism-driven therapy for diabetic cardiovascular disease
Author information +
History +
PDF

Cite this article

Download citation ▾
Fabian Sanchis-Gomar, Carl J. Lavie, Salvatore Carbone, Ian J. Neeland. Mechanism-driven therapy for diabetic cardiovascular disease. Metabolism and Target Organ Damage, 2026, 6 (2) : 31 DOI:10.20517/mtod.2026.84

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Li Y,Liu S.Diabetic vascular diseases: molecular mechanisms and therapeutic strategies.Signal Transduct Target Ther2023;8:152 PMCID:PMC10086073

[2]

Sandforth A,Arreola EV.Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS).Lancet Diabetes Endocrinol2023;11:798-810

[3]

Sandforth A,Hanson RL.Prevention of type 2 diabetes through prediabetes remission without weight loss.Nat Med2025;31:3330-40 PMCID:PMC12532634

[4]

Chen L,Yang X.Energy metabolism in cardiovascular diseases: unlocking the hidden powerhouse of cardiac pathophysiology.Front Endocrinol2025;16:1617305 PMCID:PMC12176563

[5]

Karakasis P,Iliakis P.Inflammation and resolution in obesity-related cardiovascular disease.Int J Mol Sci2026;27:535 PMCID:PMC12786577

[6]

Karwi QG,Lopaschuk GD.The contribution of cardiac fatty acid oxidation to diabetic cardiomyopathy severity.Cells2021;10:3259 PMCID:PMC8621814

[7]

Sabe SA,Sellke FW.Mechanisms and clinical implications of endothelium-dependent vasomotor dysfunction in coronary microvasculature.Am J Physiol Heart Circ Physiol2022;322:H819-41 PMCID:PMC9018047

[8]

Borg R.Glomerular hyperfiltration and tubuloglomerular feedback in diabetic kidney disease: physiological insights and potential clinical translation.J Am Soc Nephrol2025;36:342-4 PMCID:PMC11996001

[9]

Sharma N,Sharma S,Kalra S.Diabetic platelets: pathophysiology, clinical significance, and therapeutic perspectives.Diabetes Ther2025;16:2101-9 PMCID:PMC12579010

[10]

Iacobellis G.Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features.Trends Endocrinol Metab2011;22:450-7 PMCID:PMC4978122

[11]

Vyas V,Wood EG.Obesity and diabetes are major risk factors for epicardial adipose tissue inflammation.JCI Insight2021;6:e145495 PMCID:PMC8409986

[12]

Zhou Y,Zhu Y,Zhang S.Multifactorial mechanisms of obesity-related HFpEF: the central role of epicardial adipose tissue and therapeutic perspectives.Front Cardiovasc Med2025;12:1701459 PMCID:PMC12712711

[13]

Al Qassab M,Hamou A.The gut microbiota-insulin resistance axis: mechanisms, clinical implications, and therapeutic potential.FASEB Bioadv2026;8:e70080 PMCID:PMC12784175

[14]

Dong H,Nie L.Metabolic memory: mechanisms and diseases.Signal Transduct Target Ther2024;9:38 PMCID:PMC10899265

[15]

Loomba R, Hartman ML, Lawitz EJ, et al.; SYNERGY-NASH Investigators. Tirzepatide for metabolic dysfunction-associated steatohepatitis with liver fibrosis. N Engl J Med. 2024;391:299-310.

[16]

Akoumianakis I,Konstantaraki M.GLP-1 analogs and regional adiposity: a systematic review and meta-analysis.Obes Rev2023;24:e13574

[17]

Wang D,Magliano DJ.Comparison of subcutaneous, visceral, liver and muscle fat depots in relation to prevalent and incident diabetes.Diabetes Obes Metab2025;27:6304-13

[18]

Borel AL,Smith J.Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance.Int J Obes2015;39:495-501

[19]

Kabahizi A,Lieu L.Glucagon-like peptide-1 (GLP-1) signalling in the brain: from neural circuits and metabolism to therapeutics.Br J Pharmacol2022;179:600-24 PMCID:PMC8820188

[20]

Lee YH,Davies MJ.Cardiometabolic and renal benefits of sodium-glucose cotransporter 2 inhibitors.Nat Rev Endocrinol2025;21:783-98

[21]

Marx N,Lehrke M,Sattar N.GLP-1 receptor agonists for the reduction of atherosclerotic cardiovascular risk in patients with type 2 diabetes.Circulation2022;146:1882-94

[22]

McGuire DK, Marx N, Mulvagh SL, et al.; SOUL Study Group. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes. N Engl J Med. 2025;392:2001-12.

[23]

Moiz A,Tsoukas MA,Peters TM.The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions.EClinicalMedicine2025;86:103363 PMCID:PMC12303005

[24]

Lincoff AM, Brown-Frandsen K, Colhoun HM, et al.; SELECT Trial Investigators. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389:2221-32.

[25]

Deanfield J,Kahn SE.Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial.Lancet2025;406:2257-68

[26]

Nicholls SJ, Pavo I, Bhatt DL, et al.; SURPASS-CVOT Investigators. Cardiovascular outcomes with tirzepatide versus dulaglutide in type 2 diabetes. N Engl J Med. 2025;393:2409-20.

[27]

Wing RR, Bolin P, Brancati FL, et al.; Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369:145-54. PMCID:PMC3791615

[28]

Carbone S.Semaglutide in HFpEF and obesity: targeting both for functional gains.JACC Heart Fail2025;13:102665

[29]

Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al.; STEP-HFpEF Trial Committees and Investigators. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389:1069-84.

[30]

Borel AL,Smith J.Visceral and not subcutaneous abdominal adiposity reduction drives the benefits of a 1-year lifestyle modification program.Obesity2012;20:1223-33

[31]

Ross R.The future of obesity reduction: beyond weight loss.Nat Rev Endocrinol2009;5:319-25

[32]

Sattar N,Dahlqvist Leinhard O.Tirzepatide and muscle composition changes in people with type 2 diabetes (SURPASS-3 MRI): a post-hoc analysis of a randomised, open-label, parallel-group, phase 3 trial.Lancet Diabetes Endocrinol2025;13:482-93

[33]

Tuleta I.Fibrosis of the diabetic heart: clinical significance, molecular mechanisms, and therapeutic opportunities.Adv Drug Deliv Rev2021;176:113904 PMCID:PMC8444077

[34]

Nidorf SM, Fiolet ATL, Mosterd A, et al.; LoDoCo2 Trial Investigators. Colchicine in patients with chronic coronary disease. N Engl J Med. 2020;383:1838-47.

[35]

Ridker PM, Everett BM, Thuren T, et al.; CANTOS Trial Group. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377:1119-31.

[36]

Agarwal R, Filippatos G, Pitt B, et al.; FIDELIO-DKD and FIGARO-DKD investigators. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2022;43:474-84. PMCID:PMC8830527

[37]

Rodriguez PJ,Gratzl S.Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists among US adults with overweight or obesity.JAMA Netw Open2025;8:e2457349 PMCID:PMC11786232

[38]

Alissou M,Folope V.Impact of Semaglutide on fat mass, lean mass and muscle function in patients with obesity: the SEMALEAN study.Diabetes Obes Metab2026;28:112-21 PMCID:PMC12673431

[39]

Villareal DT,Gurney AB.Aerobic or resistance exercise, or both, in dieting obese older adults.N Engl J Med2017;376:1943-55 PMCID:PMC5552187

[40]

Bauer J,Cederholm T.Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group.J Am Med Dir Assoc2013;14:542-59

[41]

American Diabetes Association Professional Practice Committee for Diabetes*. 10. Cardiovascular disease and risk management: Standards of Care in Diabetes-2026.Diabetes Care2026;49:S216-45 PMCID:PMC12690187

PDF

0

Accesses

0

Citation

Detail

Sections
Recommended

/