Research Database
Novel approaches to tailor cardioprotective glucose lowering medications in older adults with type 2 diabetes based on underlying cardiovascular risk
Phyo T, MD, PhD
Institution:
Brigham and Women's Hospital
Grant Number:
4-22-PDFPM-15
Type of Grant:
Clinical
Diabetes Type:
Type 2 Diabetes
Therapeutic Goal:
Manage Diabetes
Project Date:
-
Project Status:
completed

Research Description

Older adults with high blood sugar (diabetes) are at high risk of having and dying from heart disease. Currently there is no tool to decide which of these patients with high blood sugar are at higher risk of heart disease than others. Such high-risk patients might need drugs to lower their heart disease risk. Currently, there is no evidence on which of the available medications are more beneficial for such high-risk patients. The proposed study aims to develop a tool to decide which older adults with high blood sugar have a higher risk of heart disease than others. It will be decided based on the medical history of patients. As a second step, this study will then compare which of the available drugs for high blood sugar reduce the risk of heart disease in such high-risk patients. This will help clinicians choose treatment in older adults with high blood sugar who are at higher risk of heart disease. The proposed study fills in the gap in knowledge by providing a new tool to decide which patients have higher risk of heart disease based on their medical records. This information could then be used by clinicians to decide which medications should be given to those who will most benefit from them. The study findings are useful not only for patients and clinicians but also for policy makers by helping them guide treatment decision making. This will in turn improve heart disease outcomes in older adults with high blood sugar.

Research Profile

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?

This project covers the mitigation of cardiovascular disease risk in patients with diabetes using optimal treatment regimens. Specifically, the proposed project is concerned with the stratification of cardiovascular disease risk in older adults with type 2 diabetes, using supervised machine learning methods based on electronic medical records databases, with the aim to tailor glucose lowering treatment regimens for high-risk patients that will benefit the most from such cardioprotective medications.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

This project will fill the gap in the currently available evidence by informing patients, physicians and regulators of which older patients with diabetes are at high risk of cardiovascular diseases and will benefit from the available cardioprotective glucose lowering treatment regimens, that have been shown to reduce heart disease risk. Ultimately, the project will help determine which of the available treatment regimens are most optimal for such high-risk patients with respect to their cardiovascular outcomes.

Why important for you, personally, to become involved in diabetes research? What role will this award play?

I am a primary care physician by background and have advanced training in epidemiology and pharmacoepidemiology methods related to the use of large electronic healthcare databases. My area of interest is diabetes and cardiometabolic diseases, with the aim of optimizing cardiovascular outcomes in older patients living with type 2 diabetes. This award will equip me with further research skills, experience, and clinical knowledge under mentored research training, advance my research portfolio, and help accomplish my career goals to become a researcher in the field of diabetes and cardiometabolic diseases.

In what direction do you see the future of diabetes research going?

With the availability of glucose lowering medications that lower the risk of cardiovascular diseases, the future of diabetes care research lies in the ‘precision medicine’ approach, that helps us tailor glucose lowering medications for patients who will benefit the most with minimal adverse effects. Although the current standard of care recommends glucose lowering medications for patients at high risk of heart diseases, evidence is still lacking on approaches to risk stratification, that is specifically designed for older patients with type 2 diabetes.