Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Diabetologia
Published in: Diabetologia 7/2017

01-07-2017 | Review

Diabetes, bone and glucose-lowering agents: clinical outcomes

Author: Ann V. Schwartz

Published in: Diabetologia | Issue 7/2017

Login to get access

Abstract

Older adults with diabetes are at higher risk of fracture and of complications resulting from a fracture. Hence, fracture risk reduction is an important goal in diabetes management. This review is one of a pair discussing the relationship between diabetes, bone and glucose-lowering agents; an accompanying review is provided in this issue of Diabetologia by Beata Lecka-Czernik (DOI 10.​1007/​s00125-017-4269-4). Specifically, this review discusses the challenges of accurate fracture risk assessment in diabetes. Standard tools for risk assessment can be used to predict fracture but clinicians need to be aware of the tendency for the bone mineral density T-score and the fracture risk assessment tool (FRAX) to underestimate risk in those with diabetes. Diabetes duration, complications and poor glycaemic control are useful clinical markers of increased fracture risk. Glucose-lowering agents may also affect fracture risk, independent of their effects on glycaemic control, as seen with the negative skeletal effects of the thiazolidinediones; in this review, the potential effects of glucose-lowering medications on fracture risk are discussed. Finally, the current understanding of effective fracture prevention in older adults with diabetes is reviewed.
Appendix
Available only for authorised users
Literature
1.
2.
Fan Y, Wei F, Lang Y, Liu Y (2016) Diabetes mellitus and risk of hip fractures: a meta-analysis. Osteoporos Int 27:219–228CrossRefPubMed
3.
Weber DR, Haynes K, Leonard MB, Willi SM, Denburg MR (2015) Type 1 diabetes is associated with an increased risk of fracture across the life span: a population-based cohort study using the health improvement network (THIN). Diabetes Care 38:1913–1920CrossRefPubMedPubMedCentral
4.
Bonds DE, Larson JC, Schwartz AV et al (2006) Risk of fracture in women with type 2 diabetes: the Women’s Health Initiative Observational Study. J Clin Endocrinol Metab 91:3404–3410CrossRefPubMed
5.
Janghorbani M, Van Dam RM, Willett WC, Hu FB (2007) Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol 166:495–505CrossRefPubMed
6.
Zhu ZN, Jiang YF, Ding T (2014) Risk of fracture with thiazolidinediones: an updated meta-analysis of randomized clinical trials. Bone 68:115–123CrossRefPubMed
7.
8.
Norris R, Parker M (2011) Diabetes mellitus and hip fracture: a study of 5966 cases. Injury 42:1313–1316CrossRefPubMed
9.
Hu F, Jiang C, Shen J, Tang P, Wang Y (2012) Preoperative predictors for mortality following hip fracture surgery: a systematic review and meta-analysis. Injury 43:676–685CrossRefPubMed
10.
Liao CC, Lin CS, Shih CC et al (2014) Increased risk of fracture and postfracture adverse events in patients with diabetes: two nationwide population-based retrospective cohort studies. Diabetes Care 37:2246–2252CrossRefPubMed
11.
Zura R, Xiong Z, Einhorn T et al (2016) Epidemiology of fracture nonunion in 18 human bones. JAMA Surg 151:e162775CrossRefPubMed
12.
Lee SY, Park MS, Kwon SS, Sung KH, Jung HS, Lee KM (2016) Influence of ankle fracture surgery on glycemic control in patients with diabetes. BMC Musculoskelet Disord 17:137CrossRefPubMedPubMedCentral
13.
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259CrossRefPubMedPubMedCentral
14.
15.
16.
Compston J, Bowring C, Cooper A et al (2013) Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas 75:392–396CrossRefPubMed
17.
Hernlund E, Svedbom A, Ivergard M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRefPubMedPubMedCentral
18.
Ma L, Oei L, Jiang L et al (2012) Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol 27:319–332CrossRefPubMedPubMedCentral
19.
Ahmad OS, Leong A, Miller JA et al (2016) A Mendelian randomization study of the effect of type-2 diabetes and glycemic traits on bone mineral density. J Bone Miner Res. doi:10.​1002/​jbmr.​3063
20.
Vestergaard P (2007) Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes—a meta-analysis. Osteoporos Int 18:427–444CrossRefPubMed
21.
Schwartz AV, Vittinghoff E, Bauer DC et al (2011) Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA 305:2184–2192CrossRefPubMedPubMedCentral
22.
23.
Giangregorio LM, Leslie WD, Lix LM et al (2012) FRAX underestimates fracture risk in patients with diabetes. J Bone Miner Res 27:301–308CrossRefPubMed
24.
Leslie WD, Morin SN, Lix LM, Majumdar SR (2014) Does diabetes modify the effect of FRAX risk factors for predicting major osteoporotic and hip fracture? Osteoporos Int 25:2817–2824CrossRefPubMed
25.
Leslie WD, Rubin MR, Schwartz AV, Kanis JA (2012) Type 2 diabetes and bone. J Bone Miner Res 27:2231–2237CrossRefPubMed
26.
Schacter GI, Leslie WD (2016) DXA-based measurements in diabetes: can they predict fracture risk? Calcif Tissue Int 100:150–164CrossRefPubMed
27.
Schwartz AV, Sellmeyer DE, Ensrud KE et al (2001) Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metab 86:32–38CrossRefPubMed
28.
Nicodemus KK, Folsom AR (2001) Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women. Diabetes Care 24:1192–1197CrossRefPubMed
29.
Forsen L, Meyer HE, Midthjell K, Edna TH (1999) Diabetes mellitus and the incidence of hip fracture: results from the Nord-Trondelag Health Survey. Diabetologia 42:920–925CrossRefPubMed
30.
Ivers RQ, Cumming RG, Mitchell P, Peduto AJ (2001) Diabetes and risk of fracture: The Blue Mountains Eye Study. Diabetes Care 24:1198–1203CrossRefPubMed
31.
Melton LJ 3rd, Leibson CL, Achenbach SJ, Therneau TM, Khosla S (2008) Fracture risk in type 2 diabetes: update of a population-based study. J Bone Miner Res 23:1334–1342CrossRefPubMedPubMedCentral
32.
Janghorbani M, Feskanich D, Willett WC, Hu F (2006) Prospective study of diabetes and risk of hip fracture: the Nurses’ Health Study. Diabetes Care 29:1573–1578CrossRefPubMed
33.
Hothersall EJ, Livingstone SJ, Looker HC et al (2014) Contemporary risk of hip fracture in type 1 and type 2 diabetes: a national registry study from Scotland. J Bone Miner Res 29:1054–1060CrossRefPubMed
34.
Majumdar SR, Leslie WD, Lix LM et al (2016) Longer duration of diabetes strongly impacts fracture risk assessment: the Manitoba BMD cohort. J Clin Endocrinol Metab 101:4489–4496CrossRefPubMedPubMedCentral
35.
Koh WP, Wang R, Ang LW, Heng D, Yuan JM, Yu MC (2010) Diabetes and risk of hip fracture in the Singapore Chinese Health Study. Diabetes Care 33:1766–1770CrossRefPubMedPubMedCentral
36.
Strotmeyer ES, Cauley JA, Schwartz AV et al (2005) Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study. Arch Intern Med 165:1612–1617CrossRefPubMed
37.
Viegas M, Costa C, Lopes A, Griz L, Medeiro MA, Bandeira F (2011) Prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus and their relationship with duration of the disease and chronic complications. J Diabetes Complicat 25:216–221CrossRefPubMed
38.
Strotmeyer ES, Kamineni A, Cauley JA et al (2011) Potential explanatory factors for higher incident hip fracture risk in older diabetic adults. Curr Gerontol Geriatr Res 2011:979270PubMedPubMedCentral
39.
Schwartz AV, Garnero P, Hillier TA et al (2009) Pentosidine and increased fracture risk in older adults with type 2 diabetes. J Clin Endocrinol Metab 94:2380–2386CrossRefPubMedPubMedCentral
40.
Carulli C, Innocenti M, Brandi ML (2013) Bone vascularization in normal and disease conditions. Front Endocrinol (Lausanne) 4:106
41.
Vestergaard P, Rejnmark L, Mosekilde L (2005) Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia 48:1292–1299CrossRefPubMed
42.
Johnston SS, Conner C, Aagren M, Ruiz K, Bouchard J (2012) Association between hypoglycaemic events and fall-related fractures in Medicare-covered patients with type 2 diabetes. Diabetes Obes Metab 14:634–643CrossRefPubMed
43.
Signorovitch JE, Macaulay D, Diener M et al (2012) Hypoglycaemia and accident risk in people with type 2 diabetes mellitus treated with non-insulin anti-diabetes drugs. Diabetes Obes Metab 15:335–341CrossRefPubMedPubMedCentral
44.
Schwartz AV, Margolis KL, Sellmeyer DE et al (2012) Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial. Diabetes Care 35:1525–1531CrossRefPubMedPubMedCentral
45.
Gerstein HC, Miller ME, Byington RP et al (2008) Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 358:2545–2559CrossRefPubMed
46.
Li CI, Liu CS, Lin WY et al (2015) Glycated hemoglobin level and risk of hip fracture in older people with type 2 diabetes: a competing risk analysis of Taiwan Diabetes Cohort Study. J Bone Miner Res 30:1338–1346CrossRefPubMed
47.
Oei L, Zillikens MC, Dehghan A et al (2013) High bone mineral density and fracture risk in type 2 diabetes as skeletal complications of inadequate glucose control: the Rotterdam Study. Diabetes Care 36:1619–1628CrossRefPubMedPubMedCentral
48.
Schneider AL, Williams EK, Brancati FL, Blecker S, Coresh J, Selvin E (2013) Diabetes and risk of fracture-related hospitalization: the Atherosclerosis Risk in Communities Study. Diabetes Care 36:1153–1158CrossRefPubMedPubMedCentral
49.
50.
Ensrud KE, Ewing SK, Stone KL, Cauley JA, Bowman PJ, Cummings SR (2003) Intentional and unintentional weight loss increase bone loss and hip fracture risk in older women. J Am Geriatr Soc 51:1740–1747CrossRefPubMed
51.
52.
Johnson KC Lewis CE, Womack C et al. (2016) The effect of intentional weight loss on fracture risk in diabetics: results from the Look AHEAD Clinical Trial 65: LB-80 (Abstract)
53.
Palermo A, D’Onofrio L, Eastell R, Schwartz AV, Pozzilli P, Napoli N (2015) Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review. Osteoporos Int 26:2073–2089CrossRefPubMed
54.
Kahn SE, Zinman B, Lachin JM et al (2008) Rosiglitazone associated fractures in type 2 diabetes: an analysis from ADOPT. Diabetes Care 31:845–851CrossRefPubMed
55.
56.
Billington EO, Grey A, Bolland MJ (2015) The effect of thiazolidinediones on bone mineral density and bone turnover: systematic review and meta-analysis. Diabetologia 58:2238–2246CrossRefPubMed
57.
Schwartz AV, Chen H, Ambrosius WT et al (2015) Effects of TZD use and discontinuation on fracture rates in ACCORD Bone Study. J Clin Endocrinol Metab 100:4059–4066CrossRefPubMedPubMedCentral
58.
Monami M, Dicembrini I, Antenore A, Mannucci E (2011) Dipeptidyl peptidase-4 inhibitors and bone fractures: a meta-analysis of randomized clinical trials. Diabetes Care 34:2474–2476CrossRefPubMedPubMedCentral
59.
Fu J, Zhu J, Hao Y, Guo C, Zhou Z (2016) Dipeptidyl peptidase-4 inhibitors and fracture risk: an updated meta-analysis of randomized clinical trials. Sci Rep 6:29104CrossRefPubMedPubMedCentral
60.
Mamza J, Marlin C, Wang C, Chokkalingam K, Idris I (2016) DPP-4 inhibitor therapy and bone fractures in people with type 2 diabetes—a systematic review and meta-analysis. Diabetes Res Clin Pract 116:288–298CrossRefPubMed
61.
Su B, Sheng H, Zhang M et al (2014) Risk of bone fractures associated with glucagon-like peptide-1 receptor agonists’ treatment: a meta-analysis of randomized controlled trials. Endocrine 48:107–115CrossRefPubMed
62.
Driessen JH, Henry RM, van Onzenoort HA et al (2015) Bone fracture risk is not associated with the use of glucagon-like peptide-1 receptor agonists: a population-based cohort analysis. Calcif Tissue Int 97:104–112CrossRefPubMedPubMedCentral
63.
Driessen JH, van Onzenoort HA, Starup-Linde J et al (2015) Use of glucagon-like-peptide 1 receptor agonists and risk of fracture as compared to use of other anti-hyperglycemic drugs. Calcif Tissue Int 97:506–515CrossRefPubMedPubMedCentral
64.
Taylor SI, Blau JE, Rother KI (2015) Possible adverse effects of SGLT2 inhibitors on bone. Lancet Diabetes Endocrinol 3:8–10CrossRefPubMed
65.
Ljunggren O, Bolinder J, Johansson L et al (2012) Dapagliflozin has no effect on markers of bone formation and resorption or bone mineral density in patients with inadequately controlled type 2 diabetes mellitus on metformin. Diabetes Obes Metab 14:990–999CrossRefPubMed
66.
Bilezikian JP, Watts NB, Usiskin K et al (2016) Evaluation of bone mineral density and bone biomarkers in patients with type 2 diabetes treated with canagliflozin. J Clin Endocrinol Metab 101:44–51CrossRefPubMed
67.
Watts NB, Bilezikian JP, Usiskin K et al (2016) Effects of canagliflozin on fracture risk in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab 101:157–166CrossRefPubMed
68.
Zinman B, Wanner C, Lachin JM et al (2015) Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 373:2117–2128CrossRefPubMed
69.
Lapane KL, Yang S, Brown MJ, Jawahar R, Pagliasotti C, Rajpathak S (2013) Sulfonylureas and risk of falls and fractures: a systematic review. Drugs Aging 30:527–547CrossRefPubMed
70.
71.
Majumdar SR, Josse RG, Lin M, Eurich DT (2016) Does sitagliptin affect the rate of osteoporotic fractures in type 2 diabetes? Population-based cohort study. J Clin Endocrinol Metab 101:1963–1969CrossRefPubMedPubMedCentral
72.
Rajpathak SN, Fu C, Brodovicz KG, Engel SS, Lapane K (2015) Sulfonylurea use and risk of hip fractures among elderly men and women with type 2 diabetes. Drugs Aging 32:321–327CrossRefPubMed
73.
Colhoun HM, Livingstone SJ, Looker HC et al (2012) Hospitalised hip fracture risk with rosiglitazone and pioglitazone use compared with other glucose-lowering drugs. Diabetologia 55:2929–2937CrossRefPubMedPubMedCentral
74.
Josse RG, Majumdar SR, Zheng Y, et al. (2016) Sitagliptin and risk of fractures in type 2 diabetes: results from the TECOS trial. Diabetes Obes Metab
75.
Lapane KL, Jesdale BM, Dube CE, Pimentel CB, Rajpathak SN (2015) Sulfonylureas and risk of falls and fractures among nursing home residents with type 2 diabetes mellitus. Diabetes Res Clin Pract 109:411–419CrossRefPubMed
76.
Starup-Linde J, Gregersen S, Frost M, Vestergaard P (2016) Use of glucose-lowering drugs and risk of fracture in patients with type 2 diabetes. Bone 95:136–142CrossRefPubMed
77.
Monami M, Cresci B, Colombini A et al (2008) Bone fractures and hypoglycemic treatment in type 2 diabetic patients: a case-control study. Diabetes Care 31:199–203CrossRefPubMed
78.
Ahmed LA, Joakimsen RM, Berntsen GK, Fønnebø V, Schirmer H (2006) Diabetes mellitus and the risk of non-vertebral fractures: the Tromsø study. Osteoporos Int 17:495–500CrossRefPubMed
79.
Mosenzon O, Wei C, Davidson J et al (2015) Incidence of fractures in patients with type 2 diabetes in the SAVOR-TIMI 53 trial. Diabetes Care 38:2142–2150CrossRefPubMed
80.
Thrailkill KM, Lumpkin CK Jr, Bunn RC, Kemp SF, Fowlkes JL (2005) Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues. Am J Physiol Endocrinol Metab 289:E735–E745CrossRefPubMedPubMedCentral
81.
Schwartz AV, Hillier TA, Sellmeyer DE et al (2002) Older women with diabetes have a higher risk of falls: a prospective study. Diabetes Care 25:1749–1754CrossRefPubMed
82.
American Diabetes Association (2017) Comprehensive medical evaluation and assessment of comorbidities. Diabetes Care 40(Suppl 1):S25–S32CrossRef
83.
Scragg R, Sowers M, Bell C, Third National Health and Nutrition Examination Survey (2004) Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 27:2813–2818CrossRefPubMed
84.
Feng R, Li Y, Li G et al (2015) Lower serum 25 (OH) D concentrations in type 1 diabetes: a meta-analysis. Diabetes Res Clin Pract 108:e71–e75CrossRefPubMed
85.
Institute of Medicine (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington, DC
86.
Avenell A, Mak JC, O’Connell D (2014) Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev, Issue 4, Art. no.: CD000227. doi:10.​1002/​14651858.​CD000227.​pub4
87.
Manson JE, Brannon PM, Rosen CJ, Taylor CL (2016) Vitamin D deficiency—is there really a pandemic? N Engl J Med 375:1817–1820CrossRefPubMed
88.
Black DM, Rosen CJ (2016) Clinical practice. postmenopausal osteoporosis. N Engl J Med 374:254–262CrossRefPubMed
89.
Coe LM, Tekalur SA, Shu Y, Baumann MJ, McCabe LR (2015) Bisphosphonate treatment of type I diabetic mice prevents early bone loss but accentuates suppression of bone formation. J Cell Physiol 230:1944–1953CrossRefPubMedPubMedCentral
90.
Keegan TH, Schwartz AV, Bauer DC, Sellmeyer DE, Kelsey JL (2004) Effect of alendronate on bone mineral density and biochemical markers of bone turnover in type 2 diabetic women: the fracture intervention trial. Diabetes Care 27:1547–1553CrossRefPubMed
91.
Inoue D, Muraoka R, Okazaki R, Nishizawa Y, Sugimoto T (2016) Efficacy and safety of risedronate in osteoporosis subjects with comorbid diabetes, hypertension, and/or dyslipidemia: a post hoc analysis of phase III trials conducted in Japan. Calcif Tissue Int 98:114–122CrossRefPubMed
92.
Johnell O, Kanis JA, Black DM et al (2004) Associations between baseline risk factors and vertebral fracture risk in the Multiple Outcomes of Raloxifene Evaluation (MORE) study. J Bone Miner Res 19:764–772CrossRefPubMed
93.
Ensrud KE, Stock JL, Barrett-Connor E et al (2008) Effects of raloxifene on fracture risk in postmenopausal women: the Raloxifene use for the heart trial. J Bone Miner Res 23:112–120CrossRefPubMed
94.
Vestergaard P, Rejnmark L, Mosekilde L (2011) Are antiresorptive drugs effective against fractures in patients with diabetes? Calcif Tissue Int 88:209–214CrossRefPubMed
95.
Abrahamsen B, Rubin KH, Eiken PA, Eastell R (2013) Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment: a National Prescription registry study. Osteoporos Int 24:321–328CrossRefPubMed
96.
Schwartz AV, Pavo I, Alam J et al (2016) Teriparatide in patients with osteoporosis and type 2 diabetes. Bone 91:152–158CrossRefPubMed
97.
Jennings LA, Auerbach AD, Maselli J, Pekow PS, Lindenauer PK, Lee SJ (2010) Missed opportunities for osteoporosis treatment in patients hospitalized for hip fracture. J Am Geriatr Soc 58:650–657CrossRefPubMedPubMedCentral
98.
Khosla S, Burr D, Cauley J et al (2007) Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 22:1479–1491CrossRefPubMed
99.
Shane E, Burr D, Abrahamsen B et al (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the american society for bone and mineral research. J Bone Miner Res 29:1–23CrossRefPubMed
100.
Dodson TB (2015) The frequency of medication-related osteonecrosis of the jaw and its associated risk factors. Oral Maxillofac Surg Clin North Am 27:509–516CrossRefPubMed
Metadata
Title
Diabetes, bone and glucose-lowering agents: clinical outcomes
Author
Ann V. Schwartz
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 7/2017
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-017-4283-6

Other articles of this Issue 7/2017

Diabetologia 7/2017 Go to the issue

Commentary

The elusive role of B lymphocytes and islet autoantibodies in (human) type 1 diabetes

Article

SUCNR1-mediated chemotaxis of macrophages aggravates obesity-induced inflammation and diabetes

Short Communication

EASL–EASD–EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease in severely obese people: do they lead to over-referral?

Article

Risks of asphyxia-related neonatal complications in offspring of mothers with type 1 or type 2 diabetes: the impact of maternal overweight and obesity

Article

Independent associations between a metabolic syndrome severity score and future diabetes by sex and race: the Atherosclerosis Risk In Communities Study and Jackson Heart Study

Article

Trajectories of glycaemia, insulin sensitivity and insulin secretion in South Asian and white individuals before diagnosis of type 2 diabetes: a longitudinal analysis from the Whitehall II cohort study

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits