Is Diabetes a Cardiovascular Risk Equivalent?

This transcript has been edited for clarity.

Jay H. Shubrook, DO, FAAFP, FACOFP: Hi. I'm Jay Shubrook, a board-certified family physician and fellowship-trained diabetologist at Touro University California.

Mark L. Villalon, MD, FACC: My name is Mark Villalon. I am an interventional cardiologist at NorthBay Healthcare in Fairfield, California.

Shubrook: Today's topic is one that I think we've all thought about and quite often quote. Is diabetes a cardiovascular risk equivalent?

Mark, I've worked with you. I love the work that we do together. To start this conversation, we need to know what it means when we ask, "Is diabetes a cardiovascular risk equivalent?" What's your take on that?

Villalon: Jay, thank you for having me. Diabetes, as we all know, is a progressive metabolic disease characterized by insulin resistance and eventual functional failure of pancreatic beta cells. It is the impaired glucose metabolism that is linked to higher rates of atherosclerotic cardiovascular disease (or ASCVD), morbidity, and mortality.

This is what led to the historical — and somewhat incorrect — classification of diabetes being a coronary heart disease risk equivalentwhich implies a 10-year ASCVD risk greater than 20% for every patient with diabetes. More contemporary data have shown otherwise.