Cardiometabolic medicine: time to recognize a new clinical specialty?

Diabetes, of which type 2 diabetes accounts for approximately 90% of cases, is a major preventable risk factor for cardiovascular disease that has reached pandemic proportions [1]. The presence of diabetes compounds the effects of other risk factors to increase the probability of vascular disease. Type 2 diabetes escalates the threat of heart failure, worsens the clinical course of cardiovascular diseases and shortens life expectancy albeit with variations in risk between subgroups of patients [2,3]. Although hospitalizations for acute myocardial infarction in western countries have declined in recent decades [4] diabetes continues to confer excess modifiable cardiovascular morbidity and premature mortality [5]. Encouragingly from a therapeutic standpoint, a recent study demonstrated that patients with type 2 diabetes who had five risk-factor variables within the target ranges appeared to have little or no excess risk of death, myocardial infarction, or stroke compared to the general population of Sweden [5].