Our goal is to move healthcare professionals to treat beyond HbA1C, prevent early cardiovascular and renal complications and explore non-alcoholic steatohepatitis (NASH)
Type-2 diabetes (T2D) is a medical condition in which the body cannot keep blood glucose levels normal, also known as insulin resistance. Globally, an estimated 425 million people are living with diabetes,1 and diabetes is predicted to become the seventh most common cause of death by 2030.2
People with type-2 diabetes have an increased risk of developing several serious life-threatening health problems, lowering quality of life for patients and increasing medical care costs.3-5
The pathophysiology of metabolic syndrome
The clustering of metabolic and cardiovascular risk factors in people with insulin resistance is also known as metabolic syndrome. This condition has a variety of definitions, all of which include, in addition to insulin resistance, some combination of cardiometabolic diseases like dyslipidemia (an abnormal level of lipids in the blood), obesity and hypertension.6
Risk factors for patients with type-2 diabetes
The combination of risk factors for type-2 diabetes further increases patients risk for cardiovascular and renal disease (cardiorenal).7,8 Cardiorenal diseases are early, frequent, fatal and forgotten diseases when it comes to T2D. For instance, patients with metabolic syndrome are almost twice as likely to develop chronic kidney disease (CKD) as patients without metabolic syndrome.9 Early CKD often has no sign or symptoms. A person can lose up to 90% of their kidney function before experiencing any signs.10
Diabetes and its comorbidities
Apart from constituting a substantial burden, the combination of more than one CVRM disease can also impact a patient’s mortality.1,11
- Early kidney disease in patients at age 30 years with diabetes can reduce the overall life-expectancy up to 15 years for men and 17 years for women.12
- In patients living with diabetes, the outcome after a heart attack is poorer than in patients without diabetes with increased risk for a recurrent attack, re-hospitalisation for heart failure and complicating heart failure.13
- Patients with type-2 diabetes have an increased risk of developing heart failure and patients with both diseases have about a two-fold higher risk for cardiovascular death or death from other causes than those with heart failure alone.13
Addressing diabetes and other CVRM diseases
We are investigating the drivers of disease progression and link between cardiovascular, renal and metabolic disease areas (CVRM) to explore the use of our medicines in combination that might offer unique benefits for patients. Diabetes and our efforts to positively impact patients living with this disease is summarised in this infographic.
The progress being made to transform the diabetes treatment paradigm is truly inspiring. We continue to make significant strides in treating the whole patient and push the boundaries of science in advancing this vital research.
The patient experience
What a diabetes diagnosis means for patients
Being diagnosed with diabetes can come as a shock and patients might first feel overwhelmed or deny the disease.14 Type-2 diabetes is often stigmatised and perceived as the result of poor lifestyle choices.15,16 However, with the right support, patients can learn to cope with the disease and their emotions, finding a way to manage their disease, make lifestyle changes and adapt to their new way of life.17
Navigating through cardiorenal complications in type-2 diabetes patients
We view diabetes through the additional lens of cardiovascular disease and chronic kidney disease. Many individuals suffering from type-2 diabetes may also be affected by associated cardiovascular, renal and other metabolic diseases.3 A recent survey of people age 45 and older with type-2 diabetes found that only half recognise their risk or have discussed their risk for heart attack or stroke with their health care providers.18
We want to raise awareness about the dangers of missing warning signs and the criticality in guarding against the risks of type-2 diabetes, as we are aware of the co-existence of associated conditions.
425 million adults
today suffer from diabetes. This is estimated to rise to 629 million by 2045.1
>93% of people
with type-2 diabetes have at least one other cardiovascular, renal or metabolic disease.3
6-12x higher risk
of developing end-stage renal disease in patients with type-1 diabetes.19
$1.3 trillion in 2015 to $2.5 trillion by 2030
The global economic burden of diabetes is projected to almost double.20
Today, we are focusing on developing our established treatments and medicines to help reach even more patients affected by metabolic diseases. By doing so, we hope to transform and evolve modern treatment guidelines. The call for innovation is clear for patients at unmet need and a health system in crisis. This is why we have developed industry-leading clinical programmes as well as mechanistic and extensive real-world evidence studies enabling us to identify and address those patient needs. By conducting health economics and outcomes research (HEOR), we are striving for pioneering solutions of patient care that benefit healthcare systems. Patients are at the centre of our efforts, and we want to achieve earlier response, avoiding serious outcomes for them.
Know the Danger portal for both patients and healthcare professionals
Awareness and early detection are important to decrease CV and renal (cardiorenal) risks among people living with T2D. This has motivated us to launch the Know the Danger web portal. Beyond the video we developed (see ‘The patient experience’ section above), we created an informative online site where patients with diabetes can learn about increased heart failure and renal risks and complications, which may start to develop very early on. We want patients to feel aware, motivated and resilient to address this unexpected facet of their disease. The website also encourages users to openly discuss their health and complications with their doctors to help in early detection and disease management.
Visit knowthedanger.com to learn more about managing your type-2 diabetes.
Driving healthcare system change with ACT on Diabetes
ACT – Accelerate Change Together – on Diabetes is a cross-functional programme which operates at the country level to achieve healthcare system change. Through the development of localized strategies, ACT on Diabetes seeks to promote holistic management of patients living with type-2 diabetes, calling for healthcare systems and stakeholders to protect patients from the cardio-renal complications of T2D and improve care and outcomes.
The need for innovation to optimise treatment is clear for patients living with diabetes and a health system in crisis. We constantly encourage our people to challenge the limits of science to bring us closer to our ambition: help HCPs treat beyond HbA1C, prevent early cardio-renal complications and explore deeper into the mechanisms and complications of NASH.
Discover more about CVRM
- Ogurtsova K, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40–50.
- Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.
- Arnold SV, et al. Burden of cardio-renal-metabolic conditions in adults with type 2 diabetes within the Diabetes Collaborative Registry. Diabetes Obes Metab. 2018;20(8):2000–3.
- Einarson TR, et al. Economic burden of cardiovascular disease in Type 2 Diabetes: A systematic review. Value Health. 2018;21(7):881-90.
- Trikkalinou A, et al. Type 2 diabetes and quality of life. World J Diabetes. 2017;8(4):120–9.
- Raimundo M, Lopes JA. Metabolic syndrome, chronic kidney disease, and cardiovascular disease: A dynamic and life-threatening triad. Cardiol Res Pract. 2011;2011:747861. doi: 10.4061/2011/747861
- Martín-Timón I, et al. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes. 2014;5(4):444–70.
- Goderis G, et al. Long-term evolution of renal function in patients with type 2 diabetes mellitus: A registry-based retrospective cohort study. BMJ Open. 2013;3(12):e004029.
- Lee SJ, et al. Metabolic syndrome status over 2 years predicts incident chronic kidney disease in mid-life adults: A 10-year prospective cohort study. Sci Rep. 2018;8(1):12237.
- Chronic Kidney Disease. World Kidney Day. Available from URL: www.worldkidneyday.org/faqs/chronic-kidney-disease/.
- Tune JD, et al. Cardiovascular consequences of metabolic syndrome. Transl Res. 2017;183:57–70.
- Wen CP, et al. Diabetes with early kidney involvement may shorten life expectancy by 16 years. Kidney Int. 2017;92(2):388–96.
- Ofstad AP, et al. The heart failure burden of type 2 diabetes mellitus-a review of pathophysiology and interventions. Heart Fail Rev. 2018;23(3):303–23.
- Diabetes UK. Diabetes and your emotions [cited 2019 Jul 1]. Available from URL: https://www.diabetes.org.uk/guide-to-diabetes/emotions.
- Browne JL, et al. ‘I call it the blame and shame disease’: A qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ Open. 2013;3(11):e003384.
- Liu NF, et al. Stigma in people with type 1 or type 2 diabetes. Clin Diabetes. 2017;35(1):22-34.
- Diabetes UK. Just diagnosed with diabetes: how to cope [cited 2019 Jul 1]. Available from URL: https://www.diabetes.org.uk/guide-to-diabetes/emotions/coping-diagnosis.
- American Heart Association. Know Diabetes by Heart: KNOW THE LINK; 2018 [cited 2019 Jul 1]. Available from URL: https://knowdiabetesbyheart.org/.
- Koye DN, et al. The Global Epidemiology of Diabetes and Kidney Disease. Adv Chronic Kidney Dis. 2018;25(2):121-132.
- Bommer C, et al. Global economic burden of diabetes in adults: Projections from 2015 to 2030. Diabetes Care. 2018;41(5):963–70.
Veeva ID: Z4-20775
Date of preparation: October 2019
Date of expiry: October 2021