The cardiodiabetologist: not just a question of blood glucose levels

Following the publication of numerous cardiovascular outcome studies conducted with new glucose-lowering agents, there has been a substantial change in the treatment paradigm of patients with type 2 diabetes, shifting the focus from simple glycaemic control to cardiovascular risk management. National and international guidelines of cardiology and diabetes societies have now acknowledged the important cardioprotective effects of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide receptor agonists, to the point that they are now considered first-line drugs in the management of cardiovascular risk in high-risk patients or with established cardiovascular disease, and also outside the context of established diabetes. In this brief review, we will analyse the clinical and pathophysiological evidence underlying this important paradigm shift, hypothesizing their early use in many cardiovascular patients, particularly in the pre-diabetes phase. Overall, these drugs are now a cornerstone in the therapeutic armamentarium, which the cardiologist must fully master, even independently of diabetologists.