Chronic care must address comorbidities, so what can providers do to mitigate cardiometabolic risk?
In the past, the practice of medicine viewed metabolic diseases, such as diabetes, as distinct from cardiovascular conditions like heart disease. Patients with glucose issues would come and see specialists like myself. Whereas those with heart conditions would see a cardiologist. Now we understand chronic care differently. Most people with diabetes will need to manage cardiovascular disease, and most cardiovascular diseases are indeed caused by metabolic abnormalities, hence the term cardiometabolic.
As an endocrinologist, I help many patients who are not only living with diabetes, but other cardiometabolic conditions as well. Many physicians like myself frequently evaluate and address cardiovascular risk in order to deliver the best chronic care possible. Not only that, but certain types of the newer diabetes medications can actually prevent cardiovascular events and help people with diabetes live longer, healthier lives.
As Welldoc’s Chief Medical Officer, I incorporate these clinical insights into our product development and user experience. It’s no coincidence that our top five features across our cardiometabolic products include blood glucose, food, exercise, sleep, and step entries.
Cardiovascular disease is the leading cause of death and disability for patients with type 2 diabetes. The American Diabetes Association estimates indirect healthcare costs related to diabetes in the US. This includes $37.5 billion due to the inability to work as a result of disease-related inability and $19.9 billion due to lost productive capacity as a result of early mortality.
We tend to think of cardiovascular disease as heart attacks and stroke. In addition, for people living with diabetes, the risk of heart failure doubles. And now we know that an entire new class of diabetes medications, known as SGLT2-inhibitors, actually improve heart failure outcomes.
Other than glucose, the two most common cardiovascular risk factors we address for people living with diabetes are dyslipidemia and hypertension. Comorbid hypertension is very common in people with diabetes and is a risk multiplier for cardiovascular disease.
Chronic Care for Patients
Imagine a patient walking into an endocrinologist’s office. In the past, the focus was squarely on the glucose. That’s it.
Instead, and in reality, physicians now look at the larger cardiometabolic picture. The patient’s glucose surely is important, but there may be other issues that are as important, or even more important, than glucose.
I truly value this new paradigm, this new way of thinking. Let’s talk about cardiovascular disease as an absolute, hard end-point for our patients with diabetes. It’s not just about glucose anymore.
Cardiovascular events can hurt the most, so I am excited to be able to offer my patients solutions that reduce cardiovascular risk, not just glucose. I sometimes tell my patients, “I’m not treating numbers. I’m treating people. I want you to be well and live for many years to come.”
Chronic care delivery needs one seamlessly integrated digital health solution that addresses multiple cardiometabolic factors through medications, nutrition, physical activity, and more. All while providing real-time feedback. Welldoc’s single platform offering does just that.
The reality for many of the patients we serve is a complicated process of juggling more than one cardiometabolic condition, but it doesn’t have to be.
In addition to our program for diabetes, our platform offers programming specific to hypertension and heart failure. This includes in-app content based on American Heart Association guidelines, DASH diet with low sodium food choices, blood pressure tracking, and more.
On average, 84% of our active users across our cardiometabolic products continue to use our products each month. This level of engagement is critical in self-managing cardiometabolic risk and goes beyond only tracking blood glucose.