Scholarlink

Background <p>Type 2 diabetes mellitus (T2DM) affects an estimated 463&#xa0;million adults worldwide, nearly 80% of whom live in low- and middle-income countries. Latin America and the Caribbean (LAC) are among the regions with the fastest-growing T2DM prevalence, with ~ 32&#xa0;million affected individuals- Against this background, the SIAC Prevention Council (SIAC-PREVENT) developed regionally adapted, equity-oriented recommendations for the preventive management of cardiovascular complications in T2DM.</p> Methods <p>We convened a multidisciplinary panel from across LAC and followed AGREE II and RIGHT principles. A comprehensive search (MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, SciELO, LILACS, and grey literature) from 2010 to 2025. Risk of bias was assessed using RoB 2, ROBINS-I, and AMSTAR 2; certainty of evidence was graded with GRADE. Draft recommendations were iteratively reviewed and validated in virtual meetings and an in-person consensus conference, with recorded voting procedures.</p> Findings <p>In LAC, T2DM prevalence reaches 13–14% in some countries, with high disability burden. Over 80% of patients are overweight or obese; MASLD and peripheral arterial disease are common. T2DM confers a 2–4-fold increased cardiovascular risk and higher rates of stroke and heart failure. The Council proposes an integrated, risk-based strategy combining: systematic cardiovascular risk stratification; early obesity management; a four-pillar cardiorenal approach (RAS blockade, SGLT2 inhibitors, finerenone, GLP-1 receptor agonists); preferential use of SGLT2 inhibitors and GLP-1 receptor agonists in high-risk patients; strict lipid and blood pressure control; and systematic screening and management of micro- and macrovascular complications.</p> Conclusions <p>This Ibero-American position statement supports an evidence-based and equity-oriented approach to preventing cardiovascular complications in people with T2DM in Latin America and the Caribbean. By prioritizing the use of SGLT2 inhibitors, GLP-1 receptor agonists, and structured multidisciplinary care adapted to the realities of local health systems, the region could substantially reduce morbidity, mortality, and the overall burden that T2DM represents for healthcare systems. These recommendations must be explicitly integrated into primary care models and existing chronic disease management programs within health systems. Achieving this potential will require deliberate actions to reduce inequalities in access—through coherent health policies, sustainable financing mechanisms, and continuous education for both healthcare professionals and patients—so that these strategies can be implemented at scale and in a sustainable manner. Likewise, it will be necessary to strengthen multidisciplinary care networks, establish quality indicators and outcome monitoring systems, and promote procurement and coverage strategies that facilitate equitable access to high-value therapies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Ibero-American position statement on therapeutic recommendations for the preventive management of cardiovascular complications in latin-American patients with type 2 diabetes mellitus: consensus of the prevention council of the inter-American society of cardiology (SIAC-PREVENT)

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月12日

查看全文
  • Fernando Wyss,
  • Vladimir Ullauri,
  • Joffre Lara Terán,
  • Andrés Arteaga-Arellano,
  • Carolina Gómez-Martin,
  • Ricardo Lopez-Santi,
  • Gonzalo Pérez,
  • Carlos Armando Madrigal,
  • Mayra Ger,
  • Daniel Piskorz,
  • José Gabriel Zambrano,
  • Adriana Puente-Barragán,
  • Henry las de Salas,
  • Osiris Valdez,
  • Ernesto Peñaherrera,
  • Miguel Camafort,
  • Luisa F. Aguilera,
  • Fernando Jiménez,
  • Margarita Lituma,
  • Rodrigo Alonso,
  • Máxima Méndez,
  • Karla Garay García,
  • Carlos Ponte-Negretti,
  • Liliana Cárdenas,
  • Ana Munera,
  • Ezequiel Forte,
  • Patricio Lopez – Jaramillo,
  • Raul Villar,
  • Mildren del Sueldo,
  • Yedid Valcárcel-Pérez,
  • Livia Machado,
  • Esteban Ortiz – Prado

摘要

Background

Type 2 diabetes mellitus (T2DM) affects an estimated 463 million adults worldwide, nearly 80% of whom live in low- and middle-income countries. Latin America and the Caribbean (LAC) are among the regions with the fastest-growing T2DM prevalence, with ~ 32 million affected individuals- Against this background, the SIAC Prevention Council (SIAC-PREVENT) developed regionally adapted, equity-oriented recommendations for the preventive management of cardiovascular complications in T2DM.

Methods

We convened a multidisciplinary panel from across LAC and followed AGREE II and RIGHT principles. A comprehensive search (MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, SciELO, LILACS, and grey literature) from 2010 to 2025. Risk of bias was assessed using RoB 2, ROBINS-I, and AMSTAR 2; certainty of evidence was graded with GRADE. Draft recommendations were iteratively reviewed and validated in virtual meetings and an in-person consensus conference, with recorded voting procedures.

Findings

In LAC, T2DM prevalence reaches 13–14% in some countries, with high disability burden. Over 80% of patients are overweight or obese; MASLD and peripheral arterial disease are common. T2DM confers a 2–4-fold increased cardiovascular risk and higher rates of stroke and heart failure. The Council proposes an integrated, risk-based strategy combining: systematic cardiovascular risk stratification; early obesity management; a four-pillar cardiorenal approach (RAS blockade, SGLT2 inhibitors, finerenone, GLP-1 receptor agonists); preferential use of SGLT2 inhibitors and GLP-1 receptor agonists in high-risk patients; strict lipid and blood pressure control; and systematic screening and management of micro- and macrovascular complications.

Conclusions

This Ibero-American position statement supports an evidence-based and equity-oriented approach to preventing cardiovascular complications in people with T2DM in Latin America and the Caribbean. By prioritizing the use of SGLT2 inhibitors, GLP-1 receptor agonists, and structured multidisciplinary care adapted to the realities of local health systems, the region could substantially reduce morbidity, mortality, and the overall burden that T2DM represents for healthcare systems. These recommendations must be explicitly integrated into primary care models and existing chronic disease management programs within health systems. Achieving this potential will require deliberate actions to reduce inequalities in access—through coherent health policies, sustainable financing mechanisms, and continuous education for both healthcare professionals and patients—so that these strategies can be implemented at scale and in a sustainable manner. Likewise, it will be necessary to strengthen multidisciplinary care networks, establish quality indicators and outcome monitoring systems, and promote procurement and coverage strategies that facilitate equitable access to high-value therapies.