The DOI matches its Crossref record; 332 of the 333 references it cites were found in a registry or an index; 220 of the 361 sources its claims cite were checked for support.
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026
Open accessAbstract
The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee for Diabetes, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This is the American Diabetes Association's 2026 "Standards of Care" section on cardiovascular disease and risk management in diabetes, providing graded clinical practice recommendations for blood pressure, lipids, antiplatelet therapy, and cardiovascular risk reduction. It synthesizes randomized trial and meta-analytic evidence to recommend individualized blood pressure goals (<130/80 mmHg, with <120 mmHg encouraged in high cardiovascular or kidney risk), statin-based lipid management, and cardioprotective SGLT inhibitors and/or GLP-1 receptor agonists in type 2 diabetes with ASCVD, heart failure, or CKD.
Key findings
- Blood pressure: on-treatment goal is <130/80 mmHg if safely attained, with systolic <120 mmHg encouraged in high cardiovascular or kidney risk. BPROAD (12,821 participants with type 2 diabetes) reduced the primary composite of nonfatal stroke, nonfatal MI, heart failure treatment/hospitalization, or cardiovascular death by 21% (HR 0.79, 95% CI 0.69–0.90) with achieved mean systolic 121.6 vs. 133.2 mmHg; ESPRIT (11,255 participants, 39% with type 2 diabetes) reduced its composite by 12% (HR 0.88, 95% CI 0.78–0.99); SPRINT reduced events by 25% (excluding diabetes); ACCORD BP did not reduce its primary outcome but reduced stroke by 41%.
- Lipids: moderate-intensity statin for ages 40–75 without ASCVD; high-intensity statin for higher-risk primary prevention (LDL-C goal <70 mg/dL) and for all with ASCVD (LDL-C reduction ≥50% and goal <55 mg/dL). A meta-analysis of >18,000 people with diabetes from 14 statin trials showed 9% proportional reduction in all-cause mortality and 13% in vascular mortality per 1 mmol/L (39 mg/dL) LDL-C reduction. Statin-associated diabetes risk was small (meta-analysis of 13 trials, 91,140 participants: OR 1.09; one extra diabetes case per 255 treated for 4 years while preventing 5.4 vascular events).
- Glucose-lowering agents with cardiovascular benefit: three SGLT2 inhibitors (empagliflozin, canagliflozin, dapagliflozin) and four GLP-1 RAs (liraglutide, albiglutide, semaglutide, dulaglutide) show significant cardiovascular event reductions; lixisenatide and extended-release exenatide did not. SGLT2 inhibitors reduced heart failure hospitalization (e.g., empagliflozin 35%, canagliflozin 33%, dapagliflozin 17% in respective trials).
- Antiplatelet therapy: aspirin (75–162 mg/day) is recommended for secondary prevention; for primary prevention the benefit is modest and bleeding risk increased (ASCEND: 12% reduction in primary efficacy end point, 8.5% vs. 9.6%, P = 0.01, but major bleeding 3.2% to 4.1%, rate ratio 1.29, P = 0.003).
Methods
This is a clinical practice guideline (ADA Standards of Care in Diabetes—2026, section 10), not a primary research study. Recommendations were developed by the ADA Professional Practice Committee with an evidence-grading system (grades A–E) described in the Introduction and Methodology. The evidence base is a narrative synthesis of randomized controlled trials, meta-analyses, and observational studies on blood pressure, lipid, antiplatelet, and glucose-lowering management in people with diabetes.
Limitations
Stated in the paper: no randomized trials have been specifically designed to assess cardiovascular risk reduction strategies in people with type 1 diabetes, so recommendations for type 1 diabetes are extrapolated from type 2 diabetes data; there is an absence of high-quality data to guide blood pressure goals in type 1 diabetes; very little clinical trial evidence exists for people with type 2 diabetes under age 40 or type 1 diabetes of any age for statin therapy; few older people with diabetes have been enrolled in primary prevention statin trials; and long-term outcome studies are needed to better evaluate the role of MRAs in blood pressure management. Evident from the text: this is a consensus guideline rather than a systematic review with formal meta-analytic pooling of all recommendations, and several recommendations rest on indirect or subgroup evidence (e.g., SPRINT excluded people with diabetes; some statin and PCSK9 evidence in type 1 diabetes comes from small subgroups such as 197 of 27,564 FOURIER participants).
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
71 Supported · 67 Partly supported · 62 No full text of the sources · 19 Supported so far · 6 Sources not found · 6 Own interpretation · 5 Couldn’t confirm · 2 Not supported · 1 Mixed support · 1 Not checked yet · 1 No basis given · accuracy not yet measured
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Single-pill antihypertensive combinations may improve medication-taking behavior in some individuals (60,61).”
What the sources say
- Supportedcites [60] Choudhry, 2022, Medication adherence and blood pressure control: a scientific statement from the American Heart Association, Hypertension source
The Interventions to Improve Adherence section reports that patients given polypills containing two antihypertensives were more likely to report taking their blood-pressure medications. It cautions that whether polypills specifically improve adherence remains undetermined; the claim’s tentative wording is consistent with that limitation. No page number is available in our copy. (LLM, conf=0.87)
- Disputedcites [61] Wang, 2023, Efficacy and safety of low-dose triple and quadruple combination pills vs monotherapy, usual care, or placebo for the initial management of hypertension: a systematic review and meta-analysis, JAMA Cardiol sourceExperimental — accuracy not yet measured
The Results (Adverse Effects and Tolerability; page not provided) report similar self-reported treatment adherence with low-dose combination therapy and active comparators, rather than an improvement. The paper does not report an adherence benefit for a subgroup of individuals. (LLM, conf=0.82)
Checked by a reasoning model — may be wrong.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“The CAROLINA (Cardiovascular Outcome Study of Linagliptin Versus Glimepiride in Type 2 Diabetes) study demonstrated noninferiority between a DPP-4 inhibitor, linagliptin, and a sulfonylurea, glimepiride, on cardiovascular outcomes despite lower rates of hypoglycemia in the linagliptin treatment group (267).”
What the sources say
- Disputedcites [267] Marx, 2015, Design and baseline characteristics of the CARdiovascular Outcome Trial of LINAgliptin Versus Glimepiride in Type 2 Diabetes (CAROLINA), Diab Vasc Dis Res sourceExperimental — accuracy not yet measured
The Discussion describes CAROLINA as an ongoing trial designed to test cardiovascular noninferiority, not a trial that had demonstrated it. It attributes the lower incidence of hypoglycaemia with linagliptin to a former study, not to CAROLINA results. (LLM, conf=0.91)
Checked by a reasoning model — may be wrong.
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Increasing evidence has demonstrated the benefits of GLP-1 RA or dual GIP/GLP-1 RA on symptoms and outcomes for people with HFpEF and obesity, and while most people with HFpEF have obesity, approximately 45% have diabetes (304,305).”
What the sources say
- Not checked — no full text of the sourcecites [304] Echouffo-Tcheugui, 2016, Temporal trends and factors associated with diabetes mellitus among patients hospitalized with heart failure: findings from Get With The Guidelines-Heart Failure registry, Am Heart J source
- Disputedcites [305] Haass, 2011, Body mass index and adverse cardiovascular outcomes in heart failure patients with preserved ejection fraction: results from the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial, Circ Heart Fail sourceExperimental — accuracy not yet measured
The Results, Baseline Characteristics section (page unavailable) reports that 41.3% of the HFpEF patients in the I-PRESERVE cohort had a BMI greater than 30 kg/m²—not most. The paper’s figure of more than 83% combines overweight and obese patients, so it does not support the claim that most had obesity. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Diabetes itself confers independent ASCVD risk, and among people with diabetes, all major cardiovascular risk factors, including hypertension, hyperlipidemia, and obesity, are clustered and common (2).”
What the sources say
- Partly supportedcites [2] Weng, 2019, The prevalence of cardiovascular disease and antidiabetes treatment characteristics among a large type 2 diabetes population in the United States, Endocrinol Diabetes Metab sourceExperimental — accuracy not yet measured
The Results (Study population and Subgroup analysis by age category; page unavailable) show that hypertension and dyslipidemia were common among patients with type 2 diabetes, and the Discussion reports that 45.2% had ASCVD. The paper does not establish that diabetes independently confers ASCVD risk or report obesity as a common, clustered risk factor. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“diabetes is a risk factor for incident heart failure, which is at least twofold more prevalent in people with diabetes compared with those without diabetes and is a major cause of morbidity and mortality (11).”
What the sources say
- Supportedcites [11] Kodama, 2020, Diabetes mellitus and risk of new-onset and recurrent heart failure: a systematic review and meta-analysis, ESC Heart Fail source
The Results section (‘Overall analysis of new-onset heart failure risk in relation to diabetes mellitus’; page unavailable) reports a pooled risk ratio of 2.14 for new-onset heart failure in people with diabetes compared with those without diabetes. This directly supports diabetes as a risk factor for incident heart failure. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Numerous studies have shown the efficacy of managing individual cardiovascular risk factors in preventing or slowing ASCVD in people with diabetes.”
What the sources say
- Supportedcites [3] Gæde, 2016, Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial, Diabetologia source
The Discussion (page unavailable) says single-risk-factor intervention trials reported risk reductions, although smaller than those in Steno-2, and states that lipid-lowering treatment has proven long-term benefits for CVD reduction. The paper reports these findings as background; its own trial tested multifactorial treatment. (LLM, conf=0.84)
- Supportedcites [4] Gaede, 2008, Effect of a multifactorial intervention on mortality in type 2 diabetes, N Engl J Med source
The opening passage (labeled Abstract in our copy) says trials targeting single risk factors reduced the development and progression of complications in type 2 diabetes. The Discussion specifically reports that antihypertensive and lipid-lowering drugs each reduced cardiovascular-event risk, supporting the claim about managing individual cardiovascular risk factors. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites [5] Khunti, 2018, Legacy benefits of blood glucose, blood pressure and lipid control in individuals with diabetes and cardiovascular disease: time to overcome multifactorial therapeutic inertia?, Diabetes Obes Metab source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“when all major cardiovascular risk factors are treated to within the target ranges, people with type 2 diabetes have risk of death, MI, or stroke similar to that of the general population (6).”
What the sources say
- Partly supportedcites [6] Rawshani, 2018, Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion (p. 7) reports that patients with type 2 diabetes whose five selected risk factors were within target ranges had, at most, marginally higher risks of death, myocardial infarction, and stroke than the general population. But the paper’s limitations (p. 11) say it did not distinguish patients medically treated to reach those ranges from patients already within them without treatment. The comparison is supported; attributing it specifically to treatment is not. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“people with diabetes are at risk for developing structural heart disease and HFrEF in the absence of obstructive coronary artery disease (15).”
What the sources say
- Partly supportedcites [15] Marwick, 2018, Implications of underlying mechanisms for the recognition and management of diabetic cardiomyopathy, J Am Coll Cardiol sourceExperimental — accuracy not yet measured
The Epidemiology of Diabetes-Associated HF section reports increased heart-failure risk in people with diabetes, and the paper describes structural and functional myocardial abnormalities. It does not specifically establish that people with diabetes develop HFrEF in the absence of obstructive coronary artery disease; the epidemiology section says most published data do not distinguish HFrEF from HFpEF. Page numbers were not available in our copy. (LLM, conf=0.83)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Under the current paradigm of comprehensive risk factor modification, cardiovascular morbidity and mortality have notably decreased in people with both type 1 and type 2 diabetes (1).”
What the sources say
- Supportedcites [1] Rawshani, 2017, Mortality and cardiovascular disease in type 1 and type 2 diabetes, N Engl J Med source
The Discussion reports marked reductions in mortality and cardiovascular complications among Swedish adults with both type 1 and type 2 diabetes from 1998 to 2014. It also identifies improved management of cardiovascular risk factors as an important likely contributor, while noting that the observed changes probably reflect several advances. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“People with diabetes may present with a wide spectrum of heart failure, including heart failure with preserved ejection fraction (HFpEF), heart failure with mildly reduced ejection fraction (HFmrEF), or heart failure with reduced ejection fraction (HFrEF) (12,13).”
What the sources say
- Partly supportedcites [12] Maddox, 2024 ACC expert consensus decision pathway for treatment of heart failure with reduced ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee, J Am Coll Cardiol sourceExperimental — accuracy not yet measured
Section 4.9 (page unavailable) says diabetes is common among people with HF and is strongly associated with incident HF. The paper focuses on HFrEF; our copy does not establish that people with diabetes may present across all three listed ejection-fraction categories, particularly HFpEF and HFmrEF. (LLM, conf=0.84)
- Supportedcites [13] Kittleson, 2023, 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction, J Am Coll Cardiol source
Section 7.1 reports that a trial enrolled people with type 2 diabetes and heart failure across the spectrum of left ventricular ejection fraction. Section 3.2 defines that spectrum’s HFrEF, HFmrEF, and HFpEF categories, supporting the claim that people with diabetes may have any of the three. (LLM, conf=0.90)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
- Probably not a substantial claim. 5
- It may state two separate claims as one. 66
- The quote only partly states this claim. 2
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“which is at least twofold more prevalent in people with diabetes compared with those without diabetes”
What the sources say
- Partly supportedcites [11] Kodama, 2020, Diabetes mellitus and risk of new-onset and recurrent heart failure: a systematic review and meta-analysis, ESC Heart Fail sourceExperimental — accuracy not yet measured
The Results section (Overall analysis of new-onset heart failure risk; page unavailable) reports a pooled risk ratio of 2.14 for new-onset heart failure in people with diabetes versus those without. That supports an approximately twofold higher risk, but the paper measures new-onset risk, not how prevalent heart failure is; its 95% confidence interval of 1.96–2.34 also does not establish 'at least twofold' throughout. (LLM, conf=0.87)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“only a minority of people with type 2 diabetes achieve recommended risk factor goals and are treated with guideline-recommended therapy (7–9).”
What the sources say
- Could not verifycites [7] Mohebi, 2022, Cardiovascular disease projections in the United States Based on the 2020 Census estimates, J Am Coll Cardiol sourceExperimental — accuracy not yet measured
The Results section projects diabetes prevalence, while the Methods section defines diabetes for that analysis; neither reports how many people with type 2 diabetes meet risk-factor goals or receive guideline-recommended therapy. A search for those terms and related treatment-and-control language found no passage addressing the claim in our copy. Page numbers were not available for these passages. (LLM, conf=0.75)
- Partly supportedcites [8] Kazemian, 2019, Evaluation of the cascade of diabetes care in the United States, 2005-2016, JAMA Intern Med sourceExperimental — accuracy not yet measured
The Results and Discussion (pages not provided) report that only 23% of US adults with diagnosed diabetes met the combined glycemic, blood-pressure, cholesterol, and nonsmoking goal. The paper does not establish that only a minority received guideline-recommended therapy: it reports that six in ten took a statin, but does not measure receipt of all recommended therapies. Its population is adults with diagnosed diabetes, not specifically type 2 diabetes. (LLM, conf=0.85)
- Partly supportedcites [9] Nelson, 2022, Use of lipid-, blood pressure-, and glucose-lowering pharmacotherapy in patients with type 2 diabetes and atherosclerotic cardiovascular disease, JAMA Netw Open sourceExperimental — accuracy not yet measured
The Conclusions report that fewer than 1 in 20 patients received all three evidence-based cardiovascular risk–mitigating therapies, supporting the treatment portion of the claim. The study concerns patients with both type 2 diabetes and ASCVD, not all people with type 2 diabetes. Its Results list risk-factor measurements but do not report the proportion achieving recommended risk-factor goals. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Randomized clinical trials have demonstrated unequivocally that treatment of hypertension reduces cardiovascular events as well as microvascular complications (34–40).”
What the sources say
- Not checked — no full text of the sourcecites [34] Emdin, 2015, Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis, JAMA source
- Partly supportedcites [35] Arguedas, 2013, Blood pressure targets for hypertension in people with diabetes mellitus, Cochrane Database Syst Rev sourceExperimental — accuracy not yet measured
The trial description in Acknowledgements (page unavailable) says antihypertensive drug classes had been shown to reduce cardiovascular events in people with diabetes. But the Discussion (page unavailable) reports no significant benefit of intensive blood-pressure lowering over standard control for macrovascular or microvascular events. The review compares blood-pressure targets, not treatment against no treatment, so it does not establish the claimed unequivocal reduction in both types of complication. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [36] Ettehad, 2016, Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis, Lancet source
- Partly supportedcites [37] Brunström, 2016, Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses, BMJ sourceExperimental — accuracy not yet measured
The Results (page unavailable) report fewer cardiovascular events with treatment in patients with diabetes at higher baseline systolic blood pressures, and fewer cases of end-stage renal disease only when baseline pressure exceeded 150 mm Hg. The unqualified claim overstates the evidence: below 140 mm Hg, further treatment was associated with increased cardiovascular mortality and no observed renal benefit. (LLM, conf=0.89)
- Not checked — no full text of the sourcecites [38] Bangalore, 2011, Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and Bayesian random-effects meta-analyses of randomized trials, Circulation source
- Not checked — no full text of the sourcecites [39] Thomopoulos, 2017, Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 - Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials, J Hypertens source
- Not checked — no full text of the sourcecites [40] Xie, 2016, Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis, Lancet source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“large benefits are seen when multiple cardiovascular risk factors (glycemic, blood pressure, and lipid management) are addressed simultaneously, with evidence for long-lasting benefits (3–5).”
What the sources say
- Supportedcites [3] Gæde, 2016, Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial, Diabetologia source
The Introduction (page not available) identifies hyperglycaemia, hypertension and dyslipidaemia as risk factors and describes a multifactorial intervention in patients with type 2 diabetes and microalbuminuria. The Cardiovascular disease section reports substantially fewer events with intensive therapy, while the Discussion reports a survival advantage and longer time before a first cardiovascular event over long-term follow-up. The evidence is specific to the trial’s patient population. (LLM, conf=0.92)
- Supportedcites [4] Gaede, 2008, Effect of a multifactorial intervention on mortality in type 2 diabetes, N Engl J Med source
The Results report that intensive therapy improved glycemic, blood-pressure, and lipid measures compared with conventional therapy. Over 13.3 years, the intensive-therapy group had a 29% absolute reduction in cardiovascular-event risk, with no evidence that the benefit changed after the intervention ended (Results, section labeled 586). (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [5] Khunti, 2018, Legacy benefits of blood glucose, blood pressure and lipid control in individuals with diabetes and cardiovascular disease: time to overcome multifactorial therapeutic inertia?, Diabetes Obes Metab source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“the incidence of all three conditions rises with increasing A1C levels (19).”
What the sources say
- Supportedcites [19] Honigberg, 2021, Cardiovascular and kidney outcomes across the glycemic spectrum: insights from the UK Biobank, J Am Coll Cardiol source
The Results (Incident Disease Outcomes; page not provided) report a substantial gradient of risk for ASCVD, heart failure, and CKD across HbA1c levels. Risk for all three was higher at HbA1c ≥7.0% than at <5.0%, supporting the citing sentence's broad trend; the paper also notes that risk appeared to nadir around 5.0%, so it does not claim a strictly monotonic rise at every level. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“While the relatively underpowered ACCORD (Action to Control Cardiovascular Risk in Diabetes) blood pressure trial (ACCORD BP) did not demonstrate that aiming for a systolic blood pressure <120 mmHg in people with diabetes results in decreased cardiovascular event rates, the prespecified secondary outcome of stroke was reduced by 41% with intensive treatment (45).”
What the sources say
- Supportedcites [45] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The primary composite outcome of nonfatal MI, nonfatal stroke, or death from cardiovascular causes was not significantly reduced in the intensive treatment group, although the prespecified secondary outcome of stroke was significantly reduced by 41% in the intensive treatment group.”
What the sources say
- Supportedcites [45] Cushman, 2010, Effects of intensive blood-pressure control in type 2 diabetes mellitus, N Engl J Med source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plainn = 4,733- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Antihypertensive drugs known to be effective and safe in pregnancy include methyldopa, labetalol, and long-acting nifedipine, while hydralazine may be considered in the acute management of hypertension in pregnancy or severe preeclampsia (72).”
What the sources say
- Supportedcites [72] Garovic, 2022, Hypertension in pregnancy: diagnosis, blood pressure goals, and pharmacotherapy: a scientific statement from the American Heart Association, Hypertension source
The Antihypertensive medications section identifies labetalol and methyldopa as accepted first-line treatments and says some societies also support nifedipine. It reports that parenteral hydralazine and oral nifedipine, including long-acting formulations, are among drugs studied for acute severe hypertension in pregnancy and were found comparable in safety and efficacy. The paper also notes limitations in the evidence on fetal safety. (LLM, conf=0.87)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The results of BPROAD and ESPRIT are supported by the Systolic Blood Pressure Intervention Trial (SPRINT), which demonstrated that treatment to a goal systolic blood pressure of <120 mmHg decreases cardiovascular event rates by 25% in high-risk individuals, although people with diabetes were excluded from this trial (44).”
What the sources say
- Supportedcites [44] Wright, 2015, A randomized trial of intensive versus standard blood-pressure control, N Engl J Med source
The Discussion reports a 25% lower relative risk of the primary cardiovascular outcome with a systolic blood-pressure target below 120 mm Hg versus below 140 mm Hg. It specifies that participants had hypertension without diabetes and describes the trial population as at high risk for cardiovascular events. (LLM, conf=0.94)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Treatment with ACE inhibitors and ARBs or MRAs can cause AKI and hyperkalemia, while diuretics can cause AKI and either hypokalemia or hyperkalemia (depending on mechanism of action) (77,78).”
What the sources say
- Partly supportedcites [77] Nilsson, 2017, Incidence and determinants of hyperkalemia and hypokalemia in a large healthcare system, Int J Cardiol sourceExperimental — accuracy not yet measured
The Discussion (p. 6) associates ACE inhibitors, ARBs, MRAs, and potassium-sparing diuretics with hyperkalemia risk, and identifies diuretics as a strong risk factor for hypokalemia. The paper does not establish that these treatments cause AKI. Its observational analysis also cautions that medication effects cannot be disentangled from comorbidities, so the causal wording goes beyond its findings. (LLM, conf=0.88)
- Partly supportedcites [78] Bandak, 2017, Hyperkalemia after initiating renin-angiotensin system blockade: the Stockholm Creatinine Measurements (SCREAM) project, J Am Heart Assoc sourceExperimental — accuracy not yet measured
The Introduction and Results (Risk Factors for Hyperkalemia After ACE-I/ARB Initiation; pages not provided) support hyperkalemia as a risk with ACE inhibitors and ARBs and identify potassium-sparing diuretics as a risk factor during their use. The paper does not establish the claimed AKI risks, address MRAs specifically, or support the claim that diuretics can cause hypokalemia. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the absence of albuminuria, risk of progressive kidney disease is low, and ACE inhibitors and ARBs have not been found to afford superior cardioprotection compared with thiazide-like diuretics or dihydropyridine calcium channel blockers (69).”
What the sources say
- Partly supportedcites [69] Reinhart, 2023, First-line diuretics versus other classes of antihypertensive drugs for hypertension, Cochrane Database Syst Rev sourceExperimental — accuracy not yet measured
The Authors’ Conclusions (page unavailable) report no proven clinically important advantage of other drug classes over first-line thiazides, and the Discussion reports no clear cardiovascular advantage for ACE inhibitors or ARBs over diuretics. The review does not establish that progressive kidney disease risk is low without albuminuria, or compare ACE inhibitors and ARBs directly with dihydropyridine calcium channel blockers for cardioprotection. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, heterogeneity by age has not been seen in the relative benefit of lipid-lowering therapy in trials that included older participants (100,101,104), and because older age confers higher risk, the absolute benefits are actually greater (104,112).”
What the sources say
- Not checked — no full text of the sourcecites [104] Baigent, 2005, Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins, Lancet source
- Partly supportedcites [112] Cannon, 2015, Ezetimibe added to statin therapy after acute coronary syndromes, N Engl J Med sourceExperimental — accuracy not yet measured
The Efficacy End Points section (page unavailable in our copy) says the benefit of adding ezetimibe appeared particularly pronounced in patients aged 75 or older. It does not establish that older age conferred higher baseline risk or that the greater benefit was specifically an absolute benefit caused by that risk. The trial also studied patients after acute coronary syndromes, rather than lipid-lowering therapy generally. (LLM, conf=0.82)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Use of low-dose statins was allowed in these studies and was associated with an increase in the incidence of musculoskeletal adverse effects (129,130).”
What the sources say
- Not checked — no full text of the sourcecites [129] Sullivan, 2012, Effect of a monoclonal antibody to PCSK9 on low-density lipoprotein cholesterol levels in statin-intolerant patients: the GAUSS randomized trial, JAMA source
- Supportedcites [130] Stroes, 2014, Anti-PCSK9 antibody effectively lowers cholesterol in patients with statin intolerance: the GAUSS-2 randomized, placebo-controlled phase 3 clinical trial of evolocumab, J Am Coll Cardiol source
The Methods section says GAUSS-2 enrolled patients taking no statin or a low-dose statin. The results passage under OTHER LIPIDS reports higher myalgia rates among low-dose statin users in both treatment groups, supporting the stated association with musculoskeletal adverse effects. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Individuals of childbearing potential are less likely to be treated with statins or achieve their LDL cholesterol goals based on their cardiovascular risk (138–140).”
What the sources say
- Not checked — no full text of the sourcecites [138] Agarwala, 2024, Dyslipidemia management in women of reproductive potential: an expert clinical consensus from the national lipid association, J Clin Lipidol source
- Partly supportedcites [139] Roeters van Lennep, 2023, Women, lipids, and atherosclerotic cardiovascular disease: a call to action from the European Atherosclerosis Society, Eur Heart J sourceExperimental — accuracy not yet measured
The “Call to action” section says women at high cardiovascular risk are less likely than men to be prescribed statins. The “Familial hypercholesterolaemia” section reports lower LDL-C goal attainment and interrupted statin treatment around pregnancy, but specifically for women with FH. The paper does not establish both outcomes for all individuals of childbearing potential according to cardiovascular risk. (LLM, conf=0.87)
- Partly supportedcites [140] Nanna, 2019, Sex differences in the use of statins in community practice, Circ Cardiovasc Qual Outcomes sourceExperimental — accuracy not yet measured
The Results (Statin Use and Dosing Intensity; page not provided) show that statin-eligible females were less likely than males to receive a statin or guideline-recommended intensity. The paper does not establish this specifically for individuals of childbearing potential or report whether they achieved LDL-cholesterol goals. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“It is important to note that of the ORION-3 participants, 23% had diabetes and 33% were not taking statin therapy.”
What the sources say
- Supportedcites [133] Ray, 2023, Long-term efficacy and safety of inclisiran in patients with high cardiovascular risk and elevated LDL cholesterol (ORION-3): results from the 4-year open-label extension of the ORION-1 trial, Lancet Diabetes Endocrinol source
Table 1 in the Results reports diabetes mellitus in 87/372 participants (23%) and any statin therapy in 249/374 (67%), leaving 33% not taking statins. These percentages use the participants with data available for each characteristic, rather than all 382 enrolled participants. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Bempedoic acid, a newer LDL cholesterol–lowering agent targeting the same pathway as statins but without activity in skeletal muscle, thus limiting muscle-related adverse effects, lowers LDL cholesterol levels by 15% for those on statins and 24% for those not taking statins (134).”
What the sources say
- Partly supportedcites [134] De Filippo, 2023, Safety and efficacy of bempedoic acid: a systematic review and meta-analysis of randomised controlled trials, Cardiovasc Diabetol sourceExperimental — accuracy not yet measured
The Results (page unavailable) report a 24.13% LDL-C reduction without background statin therapy and a 15.67% reduction with high-intensity statins. They report a 19.58% reduction with moderate- or low-intensity statins, so the citing sentence overgeneralizes the 15% figure to everyone taking statins. The Introduction also supports the description of bempedoic acid’s pathway and limited skeletal-muscle activity. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Reductions in LDL cholesterol ranged from 55% and 56% for evolocumab biweekly and monthly plus daily oral placebo, respectively, to 19% and 16% for ezetimibe daily plus biweekly or monthly subcutaneous placebo, respectively.”
What the sources say
- Not checked — no full text of the sourcecites [129] Sullivan, 2012, Effect of a monoclonal antibody to PCSK9 on low-density lipoprotein cholesterol levels in statin-intolerant patients: the GAUSS randomized trial, JAMA source
- Partly supportedcites [130] Stroes, 2014, Anti-PCSK9 antibody effectively lowers cholesterol in patients with statin intolerance: the GAUSS-2 randomized, placebo-controlled phase 3 clinical trial of evolocumab, J Am Coll Cardiol sourceExperimental — accuracy not yet measured
Table 2 (Efficacy Outcomes; page not supplied) supports the treatment comparisons and approximately 19% LDL-C reduction for the biweekly-placebo ezetimibe group. But it reports 56.1% for biweekly evolocumab and 55.3% for monthly evolocumab—the reverse of the cited sentence—and 16.6%, not 16%, for the monthly-placebo ezetimibe group. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Fewer musculoskeletal adverse effects occurred in those treated with evolocumab or ezetimibe than in those treated with ezetimibe plus placebo, although rates of discontinuation due to these effects were similar.”
What the sources say
- Not checked — no full text of the sourcecites [129] Sullivan, 2012, Effect of a monoclonal antibody to PCSK9 on low-density lipoprotein cholesterol levels in statin-intolerant patients: the GAUSS randomized trial, JAMA source
- Partly supportedcites [130] Stroes, 2014, Anti-PCSK9 antibody effectively lowers cholesterol in patients with statin intolerance: the GAUSS-2 randomized, placebo-controlled phase 3 clinical trial of evolocumab, J Am Coll Cardiol sourceExperimental — accuracy not yet measured
The GAUSS-2 Results report fewer muscle adverse events with evolocumab than with ezetimibe (12% versus 23%) and similar discontinuation rates due to musculoskeletal effects (5% versus 6%). They do not support the claim that ezetimibe had fewer such effects than “ezetimibe plus placebo”: the ezetimibe group received placebo injections. This paper reports GAUSS-2, not OSLER. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Of the 27,564 participants in FOURIER, 197 (0.7%) had type 1 diabetes and 10,834 (39.3%) had type 2 diabetes.”
What the sources say
- Supportedcites [114] Kang, 2025, Cardiovascular outcomes and efficacy of the PCSK9 inhibitor evolocumab in individuals with type 1 diabetes: insights from the FOURIER trial, Diabetes Care source
The Results (Baseline Characteristics) give the FOURIER total as 27,564 participants and report 197 (0.7%) with type 1 diabetes and 10,834 (39.3%) with type 2 diabetes. These figures exactly match the citing sentence. (LLM, conf=0.95)
plainn = 27,564- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“It is important to note that ∼19% of individuals were on very-low-dose statin therapy at baseline (135).”
What the sources say
- Partly supportedcites [135] Nissen, 2023, Bempedoic acid and cardiovascular outcomes in statin-intolerant patients, N Engl J Med sourceExperimental — accuracy not yet measured
The Trial Population section says patients taking a very low average daily statin dose could enroll. The Results report that 22.7% of participants were taking a statin at baseline, but do not establish that approximately 19% were taking a very-low-dose statin. (LLM, conf=0.83)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Although the evidence is limited, statins did not increase teratogenic effects for individuals with familial hypercholesterolemia (141,142), and a meta-analysis of pravastatin in pregnant individuals showed a reduction in preeclampsia, premature birth, and neonatal intensive care unit admissions (143).”
What the sources say
- Supportedcites [143] Mészáros, 2022, Pravastatin in preeclampsia: a meta-analysis and systematic review, Front Med (Lausanne) source
The Abstract Results and Discussion §4.1 report lower rates of preeclampsia, preterm birth, and NICU admission in the pravastatin meta-analysis. The analysis concerned treatment started before 20 weeks of gestation in patients at high risk of preeclampsia; the paper describes the neonatal findings as promising rather than definitive. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“There were similar rates of any adverse event for all treatments; however, fewer events that led to treatment discontinuation and few skeletal muscle–related adverse events occurred with alirocumab (128).”
What the sources say
- Supportedcites [128] Moriarty, 2015, Efficacy and safety of alirocumab vs ezetimibe in statin-intolerant patients, with a statin rechallenge arm: the ODYSSEY ALTERNATIVE randomized trial, J Clin Lipidol source
Table 3 (24-week safety results; page not provided) reports similar rates of any adverse event across the three arms: 82.5% with alirocumab, 80.6% with ezetimibe, and 85.7% with atorvastatin. Adverse events leading to discontinuation and skeletal muscle-related adverse events were less frequent with alirocumab than with either comparator. The Safety and tolerability section qualifies that the muscle-event difference was statistically significant versus atorvastatin, but not versus ezetimibe. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Previous randomized controlled trials of aspirin, specifically in people with diabetes, failed to consistently show a significant reduction in overall ASCVD end points, raising questions about the efficacy of aspirin for primary prevention in people with diabetes, although some sex differences were suggested (169–171).”
What the sources say
- Partly supportedcites [169] Belch, 2008, The Prevention of Progression of Arterial Disease and Diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease, BMJ sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [170] Zhang, 2010, Aspirin for primary prevention of cardiovascular events in patients with diabetes: a meta-analysis, Diabetes Res Clin Pract source
- Supportedcites [171] De Berardis, 2009, Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials, BMJ source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In contrast, major bleeding was significantly increased from 3.2 to 4.1% in the aspirin group (rate ratio 1.29; P = 0.003), with most of the excess being gastrointestinal bleeding and other extracranial bleeding.”
What the sources say
- Supportedcites [173] Bowman, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
The Results (p. 1) report major bleeding in 4.1% of the aspirin group versus 3.2% of the placebo group (rate ratio 1.29; P = 0.003). The same passage states that most of the excess was gastrointestinal and other extracranial bleeding. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Several studies have reported a modestly increased risk of incident type 2 diabetes with statin use (156,157), which may be limited to those with diabetes risk factors and/or impaired glucose tolerance.”
What the sources say
- Supportedcites [156] Rajpathak, 2009, Statin therapy and risk of developing type 2 diabetes: a meta-analysis, Diabetes Care source
The Conclusions (page not supplied) report a small, statistically significant increase in incident diabetes in the meta-analysis of five hypothesis-testing trials, while noting that the increase was not significant when all available trials were included. They also suggest that statins may uncover diabetes in high-risk individuals and note that 77% of JUPITER statin recipients who developed diabetes had impaired fasting glucose at entry. This supports the citing sentence’s tentative wording, not a demonstrated restriction of risk to that group. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [157] Sattar, 2010, Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials, Lancet source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“There were no significant differences by sex, weight, or duration of diabetes or other baseline factors, including ASCVD risk score.”
What the sources say
- Supportedcites [173] Bowman, 2018, Effects of aspirin for primary prevention in persons with diabetes mellitus, N Engl J Med source
The subgroup-results section (p. 6) reports no clear evidence that aspirin’s proportional effects on vascular events or major bleeding varied by baseline characteristics, including baseline vascular-risk group. The Discussion (p. 9) also says an anticipated difference by body weight was not confirmed. These were exploratory analyses, so the finding is an absence of significant variation, not proof that effects were identical. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the PROMINENT trial, in people with type 2 diabetes and elevated triglycerides (≥200 mg/dL and low HDL [≤40 mg/dL]), pemafibrate 0.2 mg twice daily reduced triglycerides by 26% but did not reduce the risk of the primary outcome of nonfatal MI, nonfatal stroke, hospitalization for unplanned coronary revascularization, or cardiovascular death (151).”
What the sources say
- Partly supportedcites [151] Das Pradhan, 2022, Triglyceride lowering with pemafibrate to reduce cardiovascular risk, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Neither the ACCORD-lipid trial nor the Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes (PROMINENT) trial, both conducted in people with type 2 diabetes on statin therapy, found that the fibrate fenofibrate or pemafibrate improved cardiovascular outcomes (150,151).”
What the sources say
- Not checked — no full text of the sourcecites [150] Maki, 2016, Triglyceride-lowering therapies reduce cardiovascular disease event risk in subjects with hypertriglyceridemia, J Clin Lipidol source
- Supportedcites [151] Das Pradhan, 2022, Triglyceride lowering with pemafibrate to reduce cardiovascular risk, N Engl J Med source
The Results (p. 2) report no reduction in cardiovascular events with pemafibrate in PROMINENT. The Discussion (p. 10) describes those neutral findings as consistent with the ACCORD trial of fenofibrate and says that, unlike FIELD, these trials involved patients receiving statins. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The largest reduction was for nonfatal MI, with little effect on CHD death (relative risk 0.95 [95% CI 0.78–1.15]) or total stroke.”
What the sources say
- Partly supportedcites [172] Baigent, 2009, Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials, Lancet sourceExperimental — accuracy not yet measured
The Results report that, in primary prevention trials, the reduction in coronary events came mainly from fewer nonfatal MIs, with no clear reduction in CHD mortality. They give the CHD-death estimate as RR 0.95 with a 99% CI of 0.78–1.15, not the claimed 95% CI. The Results also report no net effect on total stroke in primary prevention, but a significant reduction in total stroke in secondary prevention; the claim omits that distinction. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Two other large, randomized trials of aspirin for primary prevention, in people without diabetes (ARRIVE [Aspirin to Reduce Risk of Initial Vascular Events]) (174) and in the elderly (ASPREE [Aspirin in Reducing Events in the Elderly]) (175), in which 11% of participants had diabetes, found no benefit of aspirin on the primary efficacy end point and an increased risk of bleeding.”
What the sources say
- Supportedcites [174] Gaziano, 2018, Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial, Lancet source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [175] McNeil, 2018, Effect of aspirin on cardiovascular events and bleeding in the healthy elderly, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Coronary calcium scoring in asymptomatic people with diabetes may help in risk stratification (203,204) and provide reasoning for treatment intensification and/or guiding informed individual decision-making and willingness for medication initiation and participation.”
What the sources say
- Not checked — no full text of the sourcecites [203] Elkeles, 2008, Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes: the PREDICT study, Eur Heart J source
- Supportedcites [204] Malik, 2017, Coronary artery calcium score for long-term risk classification in individuals with type 2 diabetes and metabolic syndrome from the multi-ethnic study of atherosclerosis, JAMA Cardiol source
The Discussion states that CAC scoring identifies lower- and higher-risk people with diabetes and improves risk classification beyond standard risk scores. The Conclusions suggest that using CAC to focus treatment intensity may improve personalization of preventive therapies; they do not claim that treatment intensification has been shown to reduce events. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Evidence supports use of either ticagrelor or clopidogrel if no percutaneous coronary intervention was performed and clopidogrel, ticagrelor, or prasugrel if a percutaneous coronary intervention was performed (187).”
What the sources say
- Supportedcites [187] Vandvik, 2012, Primary and secondary prevention of cardiovascular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, Chest source
Section 3.2.1–3.2.5 recommends ticagrelor or clopidogrel for patients who have not undergone PCI, and ticagrelor, clopidogrel, or prasugrel for those who have undergone PCI with stent placement. The recommendations concern the first year after an acute coronary syndrome and specify that each drug is used with low-dose aspirin. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“While there was an increased risk of lower-limb amputation with canagliflozin in one trial (247), no significant increase in lower-limb amputations, fractures, AKI, or hyperkalemia was seen in other trials of canagliflozin (248).”
What the sources say
- Supportedcites [247] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
The Safety Outcomes section reports a higher risk of lower-limb amputation with canagliflozin than with placebo in the CANVAS program (6.3 vs. 3.4 per 1000 patient-years). This supports the first clause, to which this source is cited; the statement about other trials is attached to a different citation. (LLM, conf=0.91)
- Partly supportedcites [248] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med sourceExperimental — accuracy not yet measured
The Effects on Safety Outcomes section reports no significant increase in lower-limb amputation or fracture in this canagliflozin trial. The Trial Procedures section also notes that increased amputation risk had been identified in another trial, though that part of the citing sentence is attached to a different citation. Our copy does not establish the claimed absence of significant increases in acute kidney injury or hyperkalemia; the hyperkalemia passage only defines how those events were reported. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Risk factors associated with an increased risk for PAD in people with diabetes include age, smoking, hypertension, dyslipidemia, worse glycemic management, longer duration of diabetes, neuropathy, and retinopathy as well as a prior history of CVD (226,227).”
What the sources say
- Supportedcites [226] Adler, 2002, UKPDS 59: hyperglycemia and other potentially modifiable risk factors for peripheral vascular disease in type 2 diabetes, Diabetes Care source
The Results in the Analytical methods section identify age, higher HbA1c and systolic blood pressure, lower HDL cholesterol, current smoking, and prior cardiovascular disease as independent risk factors for incident PVD. The same section reports univariate associations for neuropathy and retinopathy and increasing PVD prevalence with longer diabetes duration. The claim says these factors are associated with risk, not that each is an independent predictor. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [227] Al-Delaimy, 2004, Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men, Am J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“People with type 2 diabetes and CKD should be considered for treatment with finerenone to reduce cardiovascular outcomes and the risk of CKD progression (239–242).”
What the sources say
- Partly supportedcites [239] Filippatos, 2022, Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial, Circulation sourceExperimental — accuracy not yet measured
The Results section (page unavailable) reports that finerenone lowered a composite cardiovascular outcome in patients with type 2 diabetes and CKD. This paper’s analyses focus on heart-failure and cardiovascular outcomes; the passages do not report that finerenone reduced CKD progression, so that part of the attributed claim is unsupported by this source. (LLM, conf=0.87)
- Partly supportedcites [240] Pitt, 2021, Cardiovascular events with finerenone in kidney disease and type 2 diabetes, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion reports fewer cardiovascular events with finerenone in the FIGARO-DKD trial. It also reports improved kidney outcomes in the earlier FIDELIO-DKD trial, but FIGARO-DKD did not find a statistically significant reduction in its main kidney composite outcome. The unqualified claim about reduced CKD progression therefore goes beyond this trial's primary kidney finding. (LLM, conf=0.85)
- Supportedcites [241] Agarwal, 2022, Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis, Eur Heart J source
The Discussion reports that, in a pooled analysis of patients with type 2 diabetes and CKD, finerenone reduced both the composite cardiovascular outcome and the composite kidney outcome compared with placebo. Its conclusion also states that finerenone reduced clinically important cardiovascular and kidney outcomes across the studied spectrum of CKD. (LLM, conf=0.94)
- Could not verifycites [242] Anker, 2021, Empagliflozin in heart failure with a preserved ejection fraction, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion reports cardiovascular benefits of empagliflozin in patients with heart failure and preserved ejection fraction. Searches for finerenone and CKD progression found no passage addressing finerenone’s effects in people with type 2 diabetes and CKD. (LLM, conf=0.77)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Similarly, in other screening studies, 26% of people with diabetes have been shown to have PAD (224), and diabetes increased the odds of having PAD by 85% (225).”
What the sources say
- Not checked — no full text of the sourcecites [224] Lange, 2004, High prevalence of peripheral arterial disease and low treatment rates in elderly primary care patients with diabetes, Exp Clin Endocrinol Diabetes source
- Supportedcites [225] Grøndal, 2015, Baseline prevalence of abdominal aortic aneurysm, peripheral arterial disease and hypertension in men aged 65-74 years from a population screening study (VIVA trial), Br J Surg source
The citation to this paper is attached to the 85% higher odds of PAD, not the separate 26% prevalence claim. Table 1 (labeled Discussion in our copy) reports a PAD odds ratio of 1.85 for diabetes mellitus among screened men aged 65–74, matching that attributed result. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“In the CANVAS Program, hospitalization from heart failure was reduced by 33% in people allocated to canagliflozin, and only 14% of individuals enrolled had a prior history of heart failure (247).”
What the sources say
- Supportedcites [247] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med source
The hospitalization-for-heart-failure figure reports a hazard ratio of 0.67 (95% CI, 0.52–0.87) for canagliflozin versus placebo, corresponding to a 33% lower hazard. Table 1 (Baseline Characteristics) reports a history of heart failure in 1461 of 10,142 participants (14.4%), consistent with the cited sentence’s rounded 14%. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the EMPA-REG OUTCOME trial, only 10% of study participants had a prior history of heart failure, and treatment with empagliflozin reduced the relative risk for hospitalization from heart failure by 35% (281).”
What the sources say
- Partly supportedcites [281] Zinman, 2015, Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes, N Engl J Med sourceExperimental — accuracy not yet measured
The Results (p. 1) report a 35% relative risk reduction in hospitalization for heart failure with empagliflozin. The Study Patients section (p. 4) refers to baseline characteristics in a supplementary table, but the passages in our copy do not establish that only 10% had a prior history of heart failure. (LLM, conf=0.85)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In the DECLARE-TIMI 58 study, only 10% of study participants had a prior history of heart failure, and dapagliflozin reduced cardiovascular mortality and hospitalization for heart failure by 17%, which was consistent across multiple study subgroups regardless of a prior history of heart failure (282).”
What the sources say
- Supportedcites [282] Wiviott, 2019, Dapagliflozin and cardiovascular outcomes in type 2 diabetes, N Engl J Med source
The trial’s subgroup figure (Discussion; page not provided) shows that about 10% of participants had a history of heart failure and gives a hazard ratio of 0.83 for the composite outcome of cardiovascular death or heart-failure hospitalization—a 17% relative reduction. The Discussion says this benefit was consistent across multiple subgroups, including participants with and without prior heart failure. The 17% figure applies to the composite outcome, not to cardiovascular mortality separately. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The SGLT2 inhibitors empagliflozin, canagliflozin, and dapagliflozin reduce the incidence of heart failure and improve heart failure–related outcomes, including hospitalization for heart failure and heart failure–related symptoms, in people with diabetes with preserved or reduced ejection fraction (242,247,248,281,286–294).”
What the sources say
- Partly supportedcites [242] Anker, 2021, Empagliflozin in heart failure with a preserved ejection fraction, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [247] Neal, 2017, Canagliflozin and cardiovascular and renal events in type 2 diabetes, N Engl J Med sourceExperimental — accuracy not yet measured
The discussion reports a lower risk of hospitalization for heart failure with canagliflozin than with placebo in patients with type 2 diabetes, while cautioning that this finding was not considered statistically significant under the prespecified testing sequence (page not specified in our copy). The paper does not establish reduced incidence of heart failure, improved heart-failure symptoms, effects of dapagliflozin or empagliflozin, or outcomes by preserved versus reduced ejection fraction. (LLM, conf=0.88)
- Partly supportedcites [248] Perkovic, 2019, Canagliflozin and renal outcomes in type 2 diabetes and nephropathy, N Engl J Med sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Dapagliflozin treatment had a lower risk of the primary outcome (HR 0.74 [95% CI 0.65–0.85]), lower risk of first worsening heart failure event (HR 0.70 [95% CI 0.59–0.83]), and lower risk of cardiovascular death (HR 0.82 [95% CI 0.69–0.98]) compared with placebo.”
What the sources say
- Supportedcites [287] McMurray, 2019, Dapagliflozin in patients with heart failure and reduced ejection fraction, N Engl J Med source
The Results (p. 2) report all three comparisons with the cited hazard ratios and confidence intervals: the primary outcome, first worsening heart failure event, and cardiovascular death. The Methods (p. 2) identify the trial population as patients with NYHA class II–IV heart failure and an ejection fraction of 40% or less. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The findings on the studied end points were consistent in both trials of heart failure with mildly reduced or preserved ejection fraction and in all five trials combined.”
What the sources say
- Supportedcites [297] Vaduganathan, 2022, SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials, Lancet source
The Results report no evidence of between-trial heterogeneity for the assessed outcomes, and the Discussion says the endpoint components were highly concordant between DELIVER and EMPEROR-Preserved. The paper also states that it found no statistical heterogeneity across all five trials for any endpoint. (LLM, conf=0.91)
plainn = 21,947- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction (EMPEROR-Preserved), the primary outcome of cardiovascular death or hospitalization for heart failure was reduced in adults with NYHA functional class I–IV and chronic HFpEF (LVEF >40%), extending the previously seen benefit in people with heart failure to those with preserved ejection fraction”
What the sources say
- Partly supportedcites [242] Anker, 2021, Empagliflozin in heart failure with a preserved ejection fraction, N Engl J Med sourceExperimental — accuracy not yet measured
The Discussion reports a lower risk of cardiovascular death or heart-failure hospitalization with empagliflozin, including in patients with or without diabetes. The Patients section specifies adults with LVEF greater than 40%, but its eligibility criterion was NYHA class II–IV, not I–IV. A table note mentions four class I patients; that does not make class I part of the stated eligibility criterion. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although there were low rates of ketoacidosis in the cardiovascular and heart failure outcomes trials evaluating SGLT inhibition, these studies excluded individuals with type 1 diabetes and/or recent history of diabetic ketoacidosis (296,298).”
What the sources say
- Partly supportedcites [296] Bhatt, 2021, Sotagliflozin in patients with diabetes and recent worsening heart failure, N Engl J Med sourceExperimental — accuracy not yet measured
The Eligibility section (p. 3) requires a diagnosis of type 2 diabetes, supporting that this trial did not enroll people with type 1 diabetes. The Safety End Points section (p. 9) mentions diabetic ketoacidosis but directs readers to a supplementary table for its rates; our copy does not report those rates or establish an exclusion for recent diabetic ketoacidosis. This trial alone also cannot establish the claim about the other outcomes trials. (LLM, conf=0.85)
- Could not verifycites [298] Musso, 2020, Assessing the risk of ketoacidosis due to sodium-glucose cotransporter (SGLT)-2 inhibitors in patients with type 1 diabetes: a meta-analysis and meta-regression, PLoS Med sourceExperimental — accuracy not yet measured
The Methods (Study selection; page unavailable) and Results (DKA; page unavailable) concern trials of SGLT2 inhibitors in people with type 1 diabetes, not the cardiovascular or heart-failure outcomes trials named in the claim. Searches for those trials’ ketoacidosis rates and exclusions, including recent DKA, found no passage addressing them in our copy. (LLM, conf=0.73)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“After 1 year of treatment, the mean change in the score was 13.7 points with semaglutide and 6.4 points with placebo, and the mean body weight was reduced by 9.8% in the group assigned to semaglutide compared with 3.4% with placebo.”
What the sources say
- Supportedcites [306] Kosiborod, 2024, Semaglutide in patients with obesity-related heart failure and type 2 diabetes, N Engl J Med source
The Abstract passage in our copy identifies STEP-HFpEF DM and reports the KCCQ-CSS changes as 13.7 points with semaglutide and 6.4 with placebo. It also reports mean body-weight changes of −9.8% and −3.4%, respectively, after 52 weeks. (LLM, conf=0.94)
plaindirectn = 616- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The selective nonsteroidal MRA finerenone was examined in the Study to Evaluate the Efficacy (Effect on Disease) and Safety of Finerenone in Participants With Heart Failure and Left Ventricular Ejection Fraction (Proportion of Blood Expelled Per Heart Stroke) Greater or Equal to 40% (FINEARTS-HF) trial of people with symptomatic HFpEF (ejection fraction ≥40%) and was found to reduce the risk of”
What the sources say
- Supportedcites [303] Solomon, 2024, Finerenone in heart failure with mildly reduced or preserved ejection fraction, N Engl J Med source
The Trial Participants section specifies symptomatic heart failure and ejection fraction of at least 40%. The Methods/Results passage reports fewer total worsening heart failure events or cardiovascular deaths with finerenone than placebo, with a rate ratio of 0.84 (95% CI, 0.74–0.95), corresponding to a 16% lower rate. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Supported
In the paper
“The primary outcome of nonfatal stroke, nonfatal MI, treatment or hospitalization for heart failure, or death from cardiovascular causes was reduced by 21% in the intensive treatment group (hazard ratio [HR] 0.79, 95% CI 0.69–0.90)”
What the sources say
- Not checked — no full text of the sourcecites [42] Bi, 2025, Intensive blood-pressure control in patients with type 2 diabetes, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The primary outcome, a composite of MI, revascularization, hospitalization for heart failure, stroke, or cardiovascular death, was significantly reduced by 12% in the intensive therapy group (HR 0.88, 95% CI 0.78–0.99) irrespective of the diagnosis of diabetes at baseline.”
What the sources say
- Not checked — no full text of the sourcecites [43] Liu, 2024, Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Participants with diabetes comprised nearly 20% of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial, which noted decreased cardiovascular events with treatment of hypertension to a systolic blood pressure goal of <130 mmHg (41).”
What the sources say
- Not checked — no full text of the sourcecites [41] Zhang, 2021, Trial of intensive blood-pressure control in older patients with hypertension, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Comorbid conditions including overweight and obesity and hypertension often precede the development of HFpEF and have been implicated in the pathophysiology of HFpEF (14).”
What the sources say
- Not checked — no full text of the sourcecites [14] Redfield, 2023, Heart failure with preserved ejection fraction: a review, JAMA source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Adverse event rates were similar in the two groups, although symptomatic hypotension and hyperkalemia were more frequent in the intensive therapy group (42).”
What the sources say
- Not checked — no full text of the sourcecites [42] Bi, 2025, Intensive blood-pressure control in patients with type 2 diabetes, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cardiovascular event rates, defined as fatal or nonfatal MI, fatal and nonfatal strokes, and all other cardiovascular events, were not significantly different between diastolic blood pressure goals (≤90 mmHg, ≤85 mmHg, and ≤80 mmHg), although the lowest incidence of cardiovascular events occurred with an achieved diastolic blood pressure of 82 mmHg.”
What the sources say
- Not checked — no full text of the sourcecites [47] Hansson, 1998, Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group, Lancet source
plainn = 18,790- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“β-Blockers are indicated in the setting of prior MI, active angina, or HFrEF but have not been shown to reduce mortality as blood pressure–lowering agents in the absence of these conditions (36,70,71).”
What the sources say
- Not checked — no full text of the sourcecites [36] Ettehad, 2016, Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis, Lancet source
- Not checked — no full text of the sourcecites [70] Carlberg, 2004, Atenolol in hypertension: is it a wise choice?, Lancet source
- Not checked — no full text of the sourcecites [71] Murphy, 2020, Heart failure with reduced ejection fraction: a review, JAMA source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cardiovascular benefit in this large meta-analysis did not depend on baseline LDL cholesterol levels and was linearly related to the LDL cholesterol reduction without a low threshold beyond which there was no benefit observed (101).”
What the sources say
- Not checked — no full text of the sourcecites [101] Kearney, 2008, Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis, Lancet source
plaincorrelationaln = 18,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Severe hypertriglyceridemia (fasting triglycerides ≥500 mg/dL [≥5.7 mmol/L] and especially >1,000 mg/dL [>11.3 mmol/L]) may warrant pharmacologic therapy (fibric acid derivatives and/or fish oil) and reduction in fat intake to reduce the risk of acute pancreatitis (145).”
What the sources say
- Not checked — no full text of the sourcecites [145] Pedersen, 2016, Nonfasting mild-to-moderate hypertriglyceridemia and risk of acute pancreatitis, JAMA Intern Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“While considering these alternative treatment plans, the addition of nonstatin treatment plans to maximum tolerated statin therapy should be considered, as these are frequently associated with improved medication-taking behavior and achievement of LDL cholesterol goals (127).”
What the sources say
- Not checked — no full text of the sourcecites [127] Cheeley, 2022, NLA scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient, J Clin Lipidol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The PCSK9 monoclonal antibodies alirocumab and evolocumab both have been shown to be effective for LDL cholesterol reduction and fewer skeletal muscle–related adverse effects when studied in populations considered statin intolerant.”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In fact, there was a possible increased risk of ischemic stroke in the AIM-HIGH trial (154) and an increased incidence of new-onset diabetes (absolute excess, 1.3 percentage points; P < 0.001) and disturbances in diabetes management among those with diabetes in the HPS2-THRIVE trial in those on combination therapy (155).”
What the sources say
- Not checked — no full text of the sourcecites [155] Landray, 2014, Effects of extended-release niacin with laropiprant in high-risk patients, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A meta-analysis of 13 randomized statin trials with 91,140 participants showed an odds ratio of 1.09 for a new diagnosis of diabetes, so that (on average) treatment of 255 individuals with statins for 4 years resulted in one additional case of diabetes while simultaneously preventing 5.4 vascular events among those 255 individuals (157).”
What the sources say
- Not checked — no full text of the sourcecites [157] Sattar, 2010, Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The risk of rhabdomyolysis is more common with higher doses of statins and renal insufficiency and appears to be higher when statins are combined with gemfibrozil (compared with fenofibrate) (152).”
What the sources say
- Not checked — no full text of the sourcecites [152] Jones, 2005, Reporting rate of rhabdomyolysis with fenofibrate + statin versus gemfibrozil + any statin, Am J Cardiol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Thus, aspirin appears to have a modest effect on ischemic vascular events, with the absolute decrease in events depending on the underlying ASCVD risk.”
What the sources say
- Not checked — no full text of the sourcecites [176] Pignone, 2006, Aspirin, statins, or both drugs for the primary prevention of coronary heart disease events in men: a cost-utility analysis, Ann Intern Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, for adults with ASCVD risk >1% per year, the number of ASCVD events prevented will be similar to the number of episodes of bleeding induced, although these complications do not have equal effects on long-term health (176).”
What the sources say
- Not checked — no full text of the sourcecites [176] Pignone, 2006, Aspirin, statins, or both drugs for the primary prevention of coronary heart disease events in men: a cost-utility analysis, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The net clinical benefit (ischemic benefit vs. bleeding risk) was improved with ticagrelor therapy in the large prespecified subgroup of individuals with history of percutaneous coronary intervention, while no net benefit was seen in individuals without prior percutaneous coronary intervention (190).”
What the sources say
- Not checked — no full text of the sourcecites [190] Bhatt, 2019, Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the U.S., the most common low-dose tablet is 81 mg, and it appears that 75–162 mg/day is optimal.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There is little evidence to support any specific dose, but using the lowest possible dose may help to reduce side effects (184).”
What the sources say
- Not checked — no full text of the sourcecites [184] Campbell, 2007, Aspirin dose for the prevention of cardiovascular disease: a systematic review, JAMA source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The major cardiovascular outcome trial of dapagliflozin (10 mg daily) did not show a reduction in the coprimary outcome of MI, stroke, or cardiovascular death but did show a significantly lower rate of the coprimary composite outcome of hospitalization for heart failure or cardiovascular death, which was driven by its effect on hospitalization for heart failure.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Notably, classical symptoms of claudication are uncommon, and almost half of people with newly diagnosed PAD were asymptomatic (223).”
What the sources say
- Not checked — no full text of the sourcecites [223] Hirsch, 2001, Peripheral arterial disease detection, awareness, and treatment in primary care, JAMA source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although the number needed to invite for screening to prevent one death was close to 170, vascular screening was associated with increased pharmacologic therapy (antiplatelet, lipid-lowering, and antihypertensive therapy), reduced in-hospital time for PAD and coronary artery disease, and reduced mortality (232).”
What the sources say
- Not checked — no full text of the sourcecites [232] Lindholt, 2017, Population screening and intervention for vascular disease in Danish men (VIVA): a randomised controlled trial, Lancet source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Treatment with carvedilol reduced mortality by 23%, and there was a 14% risk reduction for heart failure hospitalization.”
What the sources say
- Not checked — no full text of the sourcecites [279] Dargie, 2001, Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The efficacy and safety of SGLT2 inhibitors for reduction of cardiovascular and kidney events in people with type 1 diabetes is being investigated and is not currently recommended due to a significant increase of diabetic ketoacidosis and euglycemic ketoacidosis (266).”
What the sources say
- Not matchedcites [266] National Library of Medicine. ClincalTrial.gov . Sotagliflozin to Slow Kidney Function Decline in Persons With Type 1 Diabetes and Diabetic Kidney Disease (SUGARNSALT) (NCT06217302). Bethesda, MD, National Library of Medicine. Accessed 19 August 2025. Available from https://clinicaltrials.gov/study/NCT06217302
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, the numerous large randomized controlled trials report statistically significant reductions in cardiovascular events for three of the FDA-approved SGLT2 inhibitors (empagliflozin, canagliflozin, and dapagliflozin) and four FDA-approved GLP-1 RAs (liraglutide, albiglutide [although that agent was removed from the market for business reasons], semaglutide [subcutaneous and oral”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Most evidence supporting interventions to reduce cardiovascular risk in diabetes comes from trials of people with type 2 diabetes.
“Notably, most of the evidence supporting interventions to reduce cardiovascular risk in diabetes comes from trials of people with type 2 diabetes.”
The paper relies on this without support.
No randomized trials have been specifically designed to assess the impact of cardiovascular risk reduction strategies in people with type 1 diabetes.
“No randomized trials have been specifically designed to assess the impact of cardiovascular risk reduction strategies in people with type 1 diabetes.”
The paper relies on this without support.
SGLT inhibitors and/or GLP-1 RAs have demonstrated cardiovascular and kidney benefit in people with type 2 diabetes.
“major benefit observed across the spectrum of CVD, heart failure, and kidney outcomes in people with type 2 diabetes treated with sodium–glucose cotransporter (SGLT) inhibitors or glucagon-like peptide 1 receptor agonists (GLP-1 RAs).”
The paper relies on this without support.
Hypertension is a major risk factor for ASCVD, heart failure, and microvascular complications.
“Hypertension is a major risk factor for ASCVD, heart failure, and microvascular complications.”
The paper relies on this without support.
During pregnancy, treatment with ACE inhibitors, ARBs, direct renin inhibitors, MRAs, and neprilysin inhibitors are contraindicated, as they may cause fetal damage.
“During pregnancy, treatment with ACE inhibitors, ARBs, direct renin inhibitors, mineralocorticoid receptor antagonists (MRAs), and neprilysin inhibitors are contraindicated, as they may cause fetal damage.”
The paper relies on this without support.
There is an absence of high-quality data available to guide blood pressure goals in people with type 1 diabetes.
“Notably, there is an absence of high-quality data available to guide blood pressure goals in people with type 1 diabetes, but a similar blood pressure goal of <130/80 mmHg is recommended in people with type 1 diabetes.”
The paper relies on this without support.
People with type 2 diabetes have an increased prevalence of lipid abnormalities, contributing to their high risk of ASCVD.
“People with type 2 diabetes have an increased prevalence of lipid abnormalities, contributing to their high risk of ASCVD.”
The paper relies on this without support.
Glycemic management may beneficially modify plasma lipid levels, particularly in people with very high triglycerides and poor glycemic management.
“Glycemic management may also beneficially modify plasma lipid levels, particularly in people with very high triglycerides and poor glycemic management.”
The paper relies on this without support.
High-intensity statin therapy achieves an approximately ≥50% reduction in LDL cholesterol, and moderate-intensity statin therapy achieves 30–49% reductions in LDL cholesterol.
“High-intensity statin therapy will achieve an approximately ≥50% reduction in LDL cholesterol, and moderate-intensity statin plans achieve 30–49% reductions in LDL cholesterol.”
The paper relies on this without support.
Individuals <40 years of age have lower risk of developing a cardiovascular event over a 10-year period but high lifetime risk of developing CVD and experiencing an MI, stroke, or cardiovascular death.
“Individuals <40 years of age have lower risk of developing a cardiovascular event over a 10-year period; however, their lifetime risk of developing CVD and experiencing an MI, stroke, or cardiovascular death is high.”
The paper relies on this without support.
Low levels of HDL cholesterol, often associated with elevated triglyceride levels, are the most prevalent pattern of dyslipidemia in people with type 2 diabetes.
“Low levels of HDL cholesterol, often associated with elevated triglyceride levels, are the most prevalent pattern of dyslipidemia in people with type 2 diabetes.”
The paper relies on this without support.
No cardiovascular outcome trials have been performed to assess whether PCSK9 inhibitor therapy reduces ASCVD event rates in individuals at low or moderate risk for ASCVD (primary prevention).
“No cardiovascular outcome trials have been performed to assess whether PCSK9 inhibitor therapy reduces ASCVD event rates in individuals at low or moderate risk for ASCVD (primary prevention).”
The paper relies on this without support.
Trials evaluating efficacy and safety of lipid-lowering medications exclude pregnant individuals and require individuals of childbearing potential to use contraception.
“The trials evaluating the efficacy and safety of lipid-lowering medications exclude individuals who are pregnant and require individuals of childbearing potential to use contraception (some requiring two forms).”
The paper relies on this without support.
There is limited information regarding the use of lipid-lowering therapies (other than bile acid sequestrants) during pregnancy.
“There is limited information regarding the use of lipid-lowering therapies (other than bile acid sequestrants) during pregnancy.”
The paper relies on this without support.
Less evidence is available for individuals aged >75 years, as few older people with diabetes have been enrolled in primary prevention trials.
“Less evidence is available for individuals aged >75 years, as few older people with diabetes have been enrolled in primary prevention trials.”
The paper relies on this without support.
No randomized controlled trials specifically assessing cardiovascular outcomes of adding ezetimibe or PCSK9 inhibitors to statin therapy in primary prevention exist.
“While there are no randomized controlled trials specifically assessing cardiovascular outcomes of adding ezetimibe or PCSK9 inhibitors to statin therapy in primary prevention, a portion of the participants without established CVD were included in some studies, which also included participants with established CVD.”
The paper relies on this without support.
Combination therapy with a statin and fibrate is associated with an increased risk for abnormal transaminase levels, myositis, and rhabdomyolysis.
“Combination therapy (statin and fibrate) is associated with an increased risk for abnormal transaminase levels, myositis, and rhabdomyolysis.”
The paper relies on this without support.
Natriuretic peptide levels may be decreased in people with obesity, which impairs sensitivity of testing.
“Conversely, natriuretic peptide levels may be decreased in people with obesity, which impairs sensitivity of testing.”
The paper relies on this without support.
Aspirin use in individuals aged <21 years is generally contraindicated due to the associated risk of Reye syndrome.
“Aspirin use in individuals aged <21 years is generally contraindicated due to the associated risk of Reye syndrome.”
The paper relies on this without support.
Many individuals with PAD remain asymptomatic either because they limit physical activity to avoid claudication symptoms or because a comorbid condition prevents them from reaching a threshold of activity to provoke symptoms.
“Many individuals with PAD remain asymptomatic either because they limit physical activity to avoid claudication symptoms or because a comorbid condition prevents them from reaching a threshold of activity to provoke symptoms.”
The paper relies on this without support.
In the U.S., the most common low-dose aspirin tablet is 81 mg.
“In the U.S., the most common low-dose tablet is 81 mg, and it appears that 75–162 mg/day is optimal.”
The paper relies on this without support.
Current guideline-directed medical therapy for a history of MI and symptomatic stage C and D heart failure in people with diabetes is similar to that for people without diabetes.
“In general, current guideline-directed medical therapy for a history of MI and symptomatic stage C and D heart failure in people with diabetes is similar to that for people without diabetes.”
The paper relies on this without support.
The occurrence of other risk factors or situations is generally needed to precipitate the onset of diabetic ketoacidosis or euglycemic ketoacidosis with SGLT2 inhibitors.
“generally the occurrence of other risk factors or situations is needed to precipitate the onset of diabetic ketoacidosis or euglycemic ketoacidosis, including, but not limited to, a systemic illness, insulin pump malfunctions, significant reduction in insulin doses, and prolonged periods of fasting or carbohydrate restriction.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Abstract
“The STEP trial assigned 8,511 individuals aged 60–80 years with hypertension to a systolic blood pressure goal of 110 to <130 mmHg (intensive treatment) or 130 to <150 mmHg (40).”
§ Abstract
“Participants with diabetes comprised nearly 20% of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial, which noted decreased cardiovascular events with treatment of hypertension to a systolic blood pressure goal of <130 mmHg (41).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Abstract
“CKD (estimated glomerular filtration rate [eGFR] 30 to <60 mL/min/1.72 m2)”
§ Abstract
“estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2”
Citations
Cites
Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., Mattheus, M., Devins, T., Johansen, O. E., Woerle, H. J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504720 · Cited by 12,315
2018 ESC/ESH Guidelines for the management of arterial hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy339 · Cited by 10,286
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961
(2000) · New England Journal of Medicine · doi:10.1056/nejm200001203420301 · Cited by 8,663
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., Lackland, D. T., LeFevre, M. L., MacKenzie, T. D., Ogedegbe, O., et al. (2014) · JAMA · doi:10.1001/jama.2013.284427 · Cited by 7,950
Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes
Neal, B., Perkovic, V., Mahaffey, K. W., de Zeeuw, D., Fulcher, G., Erondu, N., Shaw, W., Law, G., Desai, M., & Matthews, D. R. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1611925 · Cited by 7,830
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
McMurray, J. J. V., Solomon, S. D., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Anand, I. S., Bělohlávek, J., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1911303 · Cited by 7,140
Research works printed but not linked: 3
- Arnett, 2019, 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, Circulation, 140, e596
- Jones, 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, e114
- Stogios, 2020, Advancing digital health interventions as a clinically applied science for blood pressure reduction: a systematic review and meta-analysis, Can J Cardiol, 36, 764
Cited by
Sorted by citations
Marston, N., Bohula, E. A., Bhatia, A. K., Ferrari, G. M. D., Leiter, L., Nicolau, J. C., Park, J., Murphy, S. A., Walsh, E., Liu, L., et al. (2026) · JAMA · doi:10.1001/jama.2026.3277 · Cited by 28
Chan, J. C. N., Deerochanawong, C., Khunti, K., Hassanein, M. M., & Mohan, V. (2026) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2026.113173 · Cited by 6
Lan, N. S. R., Fegan, P. G., & Jenkins, A. J. (2026) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2026.109268 · Cited by 2
Shoji, T., & Wanner, C. (2026) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.rv22048 · Cited by 2
Tiwari, D., Loh, W. J., & Aw, T. C. (2026) · LabMed · doi:10.3390/labmed3020010 · Cited by 2
“The 2026 ADA update continues to prioritize glucose-independent benefits of specific pharmacologic classes, alongside practical guidance for weight management for CKM disorders [33,34].”
InfluentialSpall, H. G. C. V., & Vardeny, O. (2026) · Heart Failure Reviews · doi:10.1007/s10741-026-10636-0 · Cited by 2
GIP in Cardiovascular and Kidney Disease: From Physiology to Pharmacology
Fano, M. D., Haurum, L. L., Andreasen, C. R., Porcellati, F., & Andersen, A. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70888 · Cited by 5
KAHL, S., Caussy, C., & Cusi, K. J. (2026) · Diabetologia · doi:10.1007/s00125-026-06817-z · Cited by 2
Braha, A., Timar, B., Sturza, A., & Timar, R. Z. (2026) · Medicina · doi:10.3390/medicina62081509 · Cited by 2
“A more strict systolic BP goal of 120 mmHg should be aimed for in individuals with high CV or kidney risk [30,31].”
Federici, M., Buzzetti, R., Candido, R., Cosmo, S. D., Pirillo, A., Russo, G., Sesti, G., & Avogaro, A. (2026) · Cardiovascular Diabetology · doi:10.1186/s12933-026-03185-1 · Cited by 1
Comparing incidence of heart failure in individuals with enlarged cardiac chambers versus diabetes
Mirjalili, S. R., Atlas, K. C., Reeves, A. P., Zhang, C., Wasserthal, J., Azimi, A., Hashemi, A., MozafaryBazargany, M., Jolfayi, A. G., Atlas, T. L., et al. (2026) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2026.101656 · Cited by 1
“The American Diabetes Association (ADA) recommends annual HF screening with NT-proBNP in this population [25].”
Maida, C. D., Scaglione, S., Norrito, R. L., Daidone, M., Pacinella, G., Marchese, A., Vutano, F., Cassataro, G., Dell’Ajra, L., Ferrantelli, S., et al. (2026) · Nutrients · doi:10.3390/nu18101592 · Cited by 2
“In this sense, precision nutrition should be regarded not as a replacement for guideline-based therapy, but as its natural extension within a truly personalised cardio-renal-metabolic model of care [84,86].”
The Triangular Interaction Between Dietary Polyphenols, Gut Microbiota and Type 2 Diabetes
Bayliss, E., Shope, L., Woodfin, S., Mair, G., Becker, M. H., & Moore, W. E. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27114782 · Cited by 1
“…recommend selecting antihyperglycemic therapies based on the presence of conditions such as atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease, as several drug classes have conferred cardiovascular and renal protective effects that extend beyond glycemic control [34].”
Ozturk, S. S., & Akyol, E. M. B. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15135049 · Cited by 1
Discontinuation of glucagon-like peptide-1 receptor agonists among US adults: A national survey
DiStefano, M. J., Zon, J., Olson, E. G., Levy, J. F., Anderson, G. F., & Alexander, G. C. (2026) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2026.32.8.903 · Cited by 2
Davies, M. J., Aroda, V. R., Bajaj, M. S., ElSayed, N. A., Giorgino, F., Green, J., Kalyani, R. R., Maruthur, N. M., Mathieu, C., Rosas, S. E., et al. (2026) · Diabetologia · doi:10.1007/s00125-026-06855-7 · Cited by 1
Self-citationVavitis, A., Anastasiou, I. A., Kounatidis, D. C., Rebelos, E., & Tentolouris, N. (2026) · Nutrients · doi:10.3390/nu18020285 · Cited by 2
“However, it should be noted that in the study population, LDL-C levels were frequently above target, which is defined as 70 mg/dL for patients at high cardiovascular risk and 55 mg/dL for those at very high cardiovascular risk [21].”
Pop‐Busui, R., REPETTO, E., Baron, J. M., et al. (2026) · Diabetes Care · doi:10.2337/dci25-0142
Trandafir, A.-I., Sima, O.-C., Manda, D. A., et al. (2026) · Diagnostics · doi:10.3390/diagnostics16050761
Cardiovascular risk equations in type 1 diabetes: from generic models to personalized prediction
Serés‐Noriega, T., Lafarga, I. A., Perea, V., Viñals, C., & Amor, A. J. (2026) · Annals of Medicine · doi:10.1080/07853890.2026.2642404 · Cited by 2
Yao, J., Huang, P., Wang, A., & Gao, H. (2026) · European journal of medical research · doi:10.1186/s40001-026-04314-y
“Furthermore, many individuals with hypertension (HP) and DM require long-term anti-PLT therapy, including aspirin or dual anti-PLT therapy, for secondary prevention of cardiovascular disease (CVD) [18–20], which may further increase bleeding risk.”
Li, S., Hu, X., & Li, T. (2026) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwag213
Desai, N. R., Inzucchi, S. E., & Wright, E. E. (2026) · Diabetes Therapy · doi:10.1007/s13300-026-01856-6
Cardiovascular Disease and Dyslipidemia in Pediatric Type 1 Diabetes
Kim, G. K., Brar, P. C., & Bansal, N. (2026) · Current Atherosclerosis Reports · doi:10.1007/s11883-026-01409-z
“However, other randomized trials have not shown consistent CV outcomes improvement data [68, 80].”
InfluentialWen, S., Wang, C., Xu, Z., Chen, L., He, Y., Ren, Y., Yuan, Y., Li, Y., Dong, M., Gong, M., et al. (2026) · Cardiovascular Diabetology · doi:10.1186/s12933-026-03164-6 · Cited by 1
“The 2023 AHA Presidential Advisory and the 2026 ESC/ADA Guidelines have formally adopted a "Multi-Organ Protection" framework [12, 31, 32].”
InfluentialLi, J. (2026) · Journal of Diabetes Investigation · doi:10.1111/jdi.70325
Evolving Heart Failure Profiles in Quebec from 1998-2021: Insights from the Vision C+ Database
Todkar, S., Marier-Tétrault, E., Turgeon, P. Y., Gélinas-Gascon, F., Couture, G., Després, P., Lortie, H., Basmadjian, L., Ahnadi, C. E., Ducharme, A., et al. (2026) · CJC Open · doi:10.1016/j.cjco.2026.04.011
“33 — 36 Sleep apnea prevalence in our study was higher in 2010-2021 (11”
Skeletal Muscle in Heart Failure
Shah, A., Scheetz, S. D., & Baliga, R. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-15734-9.00183-7
Tănăsescu, M., Rosu, A.-M., Mincă, A., Grigorie, M.-M., Timofte, D., & Ionescu, D. (2026) · Life · doi:10.3390/life16050756 · Cited by 1
“…in HF hospitalization, CV death or HF hospitalization, and renal outcomes, particularly in dedicated HF and CKD trials, whereas GLP-1 receptor agonists have shown a weaker and less uniform HF signal while retaining favorable effects on atherosclerotic and nephropathy-related outcomes [35,62].”
InfluentialLucove, J. C., CORNELIUS, E. M., Nguyen, H. T., Shah, V. N., Sherr, J. L., Kudva, Y. C., Carlson, A. L., & Wolf, W. A. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156261444998
Nguyen, N. H., Duong, T., Nguyen, T. N. T., Le, H. T., Vo, G. V., & Do, A. D. (2026) · Food & Function · doi:10.1039/d6fo00752j · Cited by 1
Current State of Cardiorenal Disease in People with Type 1 Diabetes
Fernandes, S., Hettinger, B., Ang, L. P., & Pop‐Busui, R. (2026) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2026.04.004
Zehra, A., Deng, Y., SWARNA, K. S., Herrin, J. S., Polley, E. C., Neumiller, J. J., Galindo, R. J., Umpierrez, G. E., Ross, J. S., Brito, J. P., et al. (2026) · Journal of the American Heart Association · doi:10.1161/jaha.125.046238
Self-citationRen, H., & Lai, H. (2026) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2026.1823872
“…(MACE), particularly atherosclerotic events, though their effect on heart failure hospitalization is less pronounced than SGLT2i (Table 1; 112 – 117) This differential ef fi cacy underscores the need to match therapy to patient phenotype: GLP-1RAs may be preferred in DCM patients with…”
Cumulative LDL-C Burden and Incident Acute Coronary Syndrome in Type 2 Diabetes
Saeed, A., Mohamed, Z., Aladab, A., et al. (2026) · Cardiovascular Medicine · doi:10.3390/cardiovascmed29020018
“Contemporary guidelines therefore recommend risk-based LDL-C targets in diabetes, commonly 1.8 mmol/L ( 70 mg/dL) for many high-risk primary-prevention patients and 1.4 mmol/L ( 55 mg/dL) for secondary-prevention or very-high-risk patients [7–9].”
InfluentialFernandes, S., Hettinger, B., Ang, L. P., & Pop‐Busui, R. (2026) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2026.04.007
Zhu, Y., Lin, L., Zhang, J., Jia, X., Chen, Y., Qiao, H., Li, M., Xu, Y., Xu, M., Wang, T., et al. (2026) · BMC Medicine · doi:10.1186/s12916-026-04946-1
Chuang, S., Liu, S.-C., Chien, K., Lin, C. Y., Tsai, M.-C., & Shih, H. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70915
Nikitina, O. M. (2026) · Consilium Medicum · doi:10.26442/20751753.2026.4.203689
Pinzón-Cortés, J. A., Narongkiatikhun, P., Snethlage, C. M. F., Castillo, D. D., Tommerdahl, K. L., Nadeau, K. J., & Bjornstad, P. (2026) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2026.04.014
Berkowitz, S. A., Dankovchik, J., Kuhn, M. L., Ochoa, A. M., LaPoint, M., Gao, M., Basu, S., Hudgens, M. G., Byhoff, E., & Gold, R. B. (2026) · Journal of General Internal Medicine · doi:10.1007/s11606-026-10550-z
Zhang, X., Dong, M., Wang, X., et al. (2026) · Pharmaceuticals · doi:10.3390/ph19060856
“PCSK9 inhibitors reduce LDL-cholesterol by approximately 50–65% and significantly decrease major adverse cardiovascular events when added to maximally tolerated statin therapy [3–5].”
Trenas, A., Prieto-Laín, N., Velasco, M. Á. P., Padilla-Leiva, C., Pérez-Ruiz, J. M., Ruíz-Rodríguez, F. I., Gómez‐Huelgas, R., Bernal-López, M. R., & Perez-Belmonte, L. M. (2026) · Pharmaceuticals · doi:10.3390/ph19060894 · Cited by 1
Mechanism-driven therapy for diabetic cardiovascular disease
Sanchis‐Gomar, F., Lavie, C. J., Carbone, S., & Neeland, I. J. (2026) · Metabolism and Target Organ Damage · doi:10.20517/mtod.2026.84
Kacha, G., HIGHTON, P. J., Funnell, M. P., Seidu, S., & Khunti, K. (2026) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s571581
Ahn, J., Rhee, H., Chung, H. J., Hong, E., & Ryu, J. C. (2026) · CardioMetabolic Syndrome Journal · doi:10.51789/cmsj.2026.6.e21
Diagnosing and Managing Type 2 Diabetes in South Asian Individuals: A Clinician’s Guide
NIJJAR, A., Bains, Y., & Shubrook, J. H. (2026) · Diabetes Obesity and Cardiometabolic CARE · doi:10.2337/doc26-0007
Revisiting Prameha as a Lifestyle Disorder: An Ayurvedic Perspective on Type 2 Diabetes Mellitus
Yadav, A. (2026) · International Ayurvedic Medical Journal · doi:10.46607/iamj1514062026
Qiu, L., Liu, J., & Hu, N. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1870649 · Cited by 4
Weber, K. S., Schlesinger, S., Lang, A., Goletzke, J., Övermöhle, C., Strathmann, E. A., Straßburger, K., Singh, N., Zaharia, O., Trenkamp, S., et al. (2026) · Scientific Reports · doi:10.1038/s41598-026-57026-y
“Furthermore, people with diabetes tend to accumulate major CVD risk factors more commonly as compared to the general population, further increasing their CVD risk 3 .”
Labate, A. M., Cimino, E., Giacomelli, L., Ettori, S., Oladeji, O. A., & Agosti, B. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27146170
Corrao, S., & Federici, M. (2026) · Acta Diabetologica · doi:10.1007/s00592-026-02748-8
“…in particular its prespecified analysis of patients with diabetes and no known significant atherosclerosis, invites us to question whether that distinction still deserves the central role it has long held in deciding the intensity of lipid-lowering therapy. only if LDL-C remained elevated [7, 8].”
Zeynettin, A., Balıkçı, O., & Demir, İ. (2026) · Hormone and Metabolic Research · doi:10.1055/a-2901-3276
Russo, G. T., Porto, A. D., Nicolucci, A., Ceriello, A., Muscarà, A., Rossi, M. C., Bartolo, P. D., Lucisano, G., Manicardi, V., Rocca, A., et al. (2026) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2026.113446
Racial/ethnic inequities in diabetes mellitus: a narrative review
Mazhude, T., Fanas, R. L., & Myers, A. K. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag277
Zheutlin, A. R., Jacobs, J. A., & Chaitoff, A. (2026) · Journal of the American Heart Association · doi:10.1161/jaha.126.050848
Brîndușe, L. A., Vicol, C., Cucu, M. A., & Bratu, E. C. (2026) · Diabetology · doi:10.3390/diabetology7070138
Park, Y., Kim, Y. J., Choi, B., Noh, C.-B., Kim, S. H., Bang, J., Lee, J.-E., Kang, J., & Bae, Y. S. (2026) · Journal of Medical Internet Research · doi:10.2196/82822
Salgado, T. M., Amayreh, R., Alshahawey, M., Musselman, K. T., Buffington, T. M., Hyder, H., Jones, R. M., & Dixon, D. L. (2026) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.70263
“Based on this evidence, clinical practice guidelines recommend SGLT2i and GLP-1 RA as preferred agents in patients with atherosclerotic cardiovascular disease (ASCVD), HF, or CKD [7–9].”
Self-citationThomsen, H. B., Andersen, S. T., Fagherazzi, G., et al. (2026) · doi:10.2196/preprints.105890
MASLD and Cardiovascular Risk: Mechanisms and Implications for Clinical Practice
Li, S., Toutoungy, M., Patel, J., Bhavsar‐Burke, I., & VanWagner, L. B. (2026) · Current Hypertension Reports · doi:10.1007/s11906-026-01380-9 · Cited by 1
“However, due to its association with worsening heart failure, it is not typically favored for diabetes management in patients with MASLD [83].”
Ortega-Hombrados, L., Aurioles, E. M., Sánchez‐Tévar, A. M., Vázquez-Pérez, A., Arrebola, M. M., Rodríguez-Pérez, M. D., Cruz, J. P. D. L., & Correa, J. A. G. (2026) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2026.119815
Huang, S.-C., Cheng, W.-Y., Hou, C.-Y., Wu, J.-Y., Lai, C., & Tseng, W. (2026) · Frontiers in Urology · doi:10.3389/fruro.2026.1855180
Mercantepe, F., Karahan, B., Kızılkaya, B., Çiftel, S., & Gürbüzer, N. (2026) · Eating Disorders · doi:10.1080/10640266.2026.2716232
Yihan, H., Xuelin, C., Chen, P., Ruoxi, S., Xiao, L., & Chen, M. (2026) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2026.113514
Beyond LDL-C: Modern Lipid Management for ASCVD Prevention in Primary Care
Carlson, A. M., Zayyad, Z. A., Driesenga, S., Boxley, P., Mishra, A., Uraizee, O., Ephrem, R., Zhang, R., Natsheh, Z., & Shroff, A. R. (2026) · Cardiology and Therapy · doi:10.1007/s40119-026-00473-5
Jiang, H., Liu, J., Ying, Y., et al. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1910565
Risk Factors and Their Impact on Diabetes Mellitus in Elderly People
Bilic-Komarica, E. (2026) · Annals of Clinical Endocrinology and Metabolism · doi:10.29328/journal.acem.1001036
Beyond glycemia: clinical nutrition in type 2 diabetes and cardiometabolic risk
Labate, A. M., & Villari, P. (2026) · Academia Nutrition and Dietetics · doi:10.20935/acadnutr8484
Zhussupbekova, L., Makhkamova, M., Мухтархановна, Н. Н., Nurkina, D., Yuldashov, F., & Ubaydullayev, D. (2026) · Biomedicines · doi:10.3390/biomedicines14091927
Liu, M., Kong, Y., Chen, S., et al. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1926018
Tischer, A. A., Stana, L. G., Lazureanu, P. A., Ilie, A. C., Clej, E. E., Raţiu, A., & Ilie, O. C. (2026) · Medicina · doi:10.3390/medicina62091690
“Contemporary European and American guidance therefore frames diabetes management as a cardiovascular–kidney–metabolic problem rather than an isolated disorder of glucose homeostasis [1–6].”
Pop‐Busui, R., Cuenca, A. M. C., Čeponis, J., Porto, A. D., Santos, J. D., Gavina, C., Gastaldi, G., Janež, A., Joshi, A. S., McDonald, K., et al. (2026) · Journal of General Internal Medicine · doi:10.1007/s11606-026-10791-y
Low Serum C-Peptide and Albuminuria Severity in Type 2 Diabetes Mellitus: A Cross-Sectional Study
Işık, B., & Tetıker, T. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15186950
“Hypertension was defined as a systolic blood pressure of at least 130 mmHg or a diastolic blood pressure of at least 80 mmHg, based on the average of two or more measurements obtained on two or more occasions, or current use of antihypertensive medication [21].”
Pantazopoulos, D., Mikhailidis, D. P., & Παπάνας, Ν. (2026) · The International Journal of Lower Extremity Wounds · doi:10.1177/15347346261486484
Igna, A. D., Petca, B.-L., Popovici, P.-A., Ghitea, T. C., Brata, R. D., Trifan, D. F., & Popoviciu, M. S. (2026) · Diseases · doi:10.3390/diseases14090329
“…risk markers; and eGFR https://doi.org/10.3390/diseases14090329 and UACR are used in kidney disease detection, classification, and risk assessment [4,6– 8,13, The high frequency of concurrent abnormalities observed in this cohort nevertheless emphasizes the importance of comprehensive assessment…”
InfluentialIdentification of Risk Factors for Heart Disease Based on Logistic Regression Model
Han, L., & Gao, X. (2026) · BIO Web of Conferences · doi:10.1051/bioconf/202625401014
“These risk factors drive the pathogenesis of heart disease by triggering intricate metabolic dysregulation and a series of pathophysiological cascades, such as atherosclerotic plaque formation, endothelial dysfunction, myocardial fibrosis, and adverse cardiac remodeling [10,11] .”
Clinical Evidence of Cardioprotective Effects of SGLT2 Inhibitors
Usman, M. S., Verma, S., & Pandey, A. (2026) · Handbook of experimental pharmacology · doi:10.1007/164_2026_827
Peripheral arterial disease and the link with diabetes
Morris, D. (2026) · Independent Nurse · doi:10.12968/indn.2026.9.24
Yang, H., Ren, T., Zhou, J., Liu, H., yin, F., & Liu, Z. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.71359
Torres-Benítez, A., Acierno, C., Nilo, D., et al. (2026) · Biomedicines · doi:10.3390/biomedicines14092083
“Although contemporary multifactorial management has substantially improved cardiometabolic outcomes, considerable residual risk persists [1,3].”
Holt, R. I. G., DeVries, J. H., Fischl, A. H., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, É., et al. (2026) · Diabetologia · doi:10.1007/s00125-026-06833-z
Self-citationNehme, M., Samuna, I. B., Messier, V., Dawe, P., Brazeau, A., & Taleb, N. (2026) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2026.109417
Tan, X., Liang, Y. M., 陈, 忠., Xie, L., Guevarra, M., Swift, C., & de Havenon, A. (2026) · Diabetes Therapy · doi:10.1007/s13300-026-01919-8
Cystatin C-based eGFR discordance and mortality risk in adults with dysglycemia
Wei, X., & Liu, M. (2026) · Medicine · doi:10.1097/md.0000000000050748
Ji, K., Zhang, D., Zhao, Y., Zeng, Z., Jiang, M., & Zhang, J. (2026) · Diabetes & Metabolism · doi:10.1016/j.diabet.2026.101793
Type 1 diabetes and cardiovascular medicine
Jenkins, A. J., Huang, M., Hemphill, M., Chen, D., Ha, J. T., Sata, Y., Sindone, A. P., Gnanenthiran, S. R., & Lan, N. S. R. (2026) · Cardiovascular Diabetology – Endocrinology Reports · doi:10.1186/s40842-026-00338-9
“Consideration of adjunct metformin has been mentioned in American Diabetes Association (ADA) guidelines [40], pramlintide is FDA-approved [41], and SGTL2 inhibitors are approved in Japan for metabolic benefit and was approved in Europe, but the drug company revoked the T1D indication.”
InfluentialWisseh, C., Lee, J., Loeza, M., et al. (2026) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-026-01999-5
Bonab, L. N. H., Moazzam‐Jazi, M., Abooshahab, R., Heydarzadeh, S., DANESHPOUR, M. S., & Hedayati, M. (2026) · Cardiovascular Toxicology · doi:10.1007/s12012-026-10192-x
Ahmed, M. J., Ahmad, A. M., Naqvi, S., Ahmed, K., Ahmed, A., & Naqvi, Z. (2026) · Cureus · doi:10.7759/cureus.116699
Tischer, A. A., Stana, L. G., Ilie, O. C., Ilie, A. C., Craciun, L. R., Căpraru, I. D., & Clej, E. E. (2026) · Medicina · doi:10.3390/medicina62101825
Simeanu, G.-M. C., Glodeanu, A. D., Protasiewicz-Timofticiuc, D.-C., Popa, A.-L., Mitrea, A., Efrem, I. C., Clenciu, D., Mirea, A. A., Mitroi, D. M., Dragne, I.-G., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15197461
Takahara, M., Soga, Y., & Iida, O. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag387
Pan, J., Guo, C., Huang, Q., Zhang, Y., Shen, Y., & Guo, C. (2026) · British Journal of Hospital Medicine · doi:10.31083/bjhm55884
The impact of plant-based diets on the prevention and treatment of type 2 diabetes
Tsamkiranis, F., Wong, M., Nagra, M., & Ur, E. (2026) · Academia Nutrition and Dietetics · doi:10.20935/acadnutr8528
Ibrahim, H., Siddiqi, F. A., Ahmad, E., Siddiqi, K. A., Qureshi, M. N., & Saeed, S. (2026) · Journal of Rawalpindi Medical College · doi:10.37939/jrmc.3345
Fu, M., Liu, X., Shi, T., Lu, Y., Zou, J., 黄小薇, Pan, Q., Chen, Y., & Zhong, Y. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1964592
The cardiometabolic continuum: A new approach to prevention and care
Talwar, K. K., & Madhu, S. (2026) · Annals of the National Academy of Medical Sciences (India) · doi:10.25259/anams_223_2026
Miceli, G., Basso, M. G., Cuffaro, M., Marchese, A., & Tuttolomondo, A. (2026) · Medicina · doi:10.3390/medicina62101905
Mohamed, A. A., Husain, B. H., Dali, T. K., Ahmed, M. E., Shawawreh, G. A., Samir, A., Moussa, M. A., Hibysh, A. M., Shehata, A. G. S. F., Ramadan, Y., et al. (2026) · Cardiovascular Therapeutics · doi:10.1155/cdr/8933859
Metadata
- Authors
- American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., Das, S. R., Dixon, D. L., Echouffo-Tcheugui, J. B., Everett, B. M., Garg, R., Laffel, L. M., Lal, R., Matfin, G., Pandya, N., Pekas, E. J., Peters, A. L., Pilla, S. J., Romeo, G. R., Rosas, S. E., Segal, A. R., Szmuilowicz, E. D., & ElSayed, N. A.
- ORCID
- Bajaj, Mandeep
- McCoy, Rozalina G.
- Balapattabi, Kirthikaa
- Bannuru, Raveendhara R.
- Bellini, Natalie J.
- Bennett, Allison K.
- Beverly, Elizabeth A.
- Briggs Early, Kathaleen
- ChallaSivaKanaka, Sathyavathi
- Das, Sandeep R.
- Dixon, Dave L.
- Echouffo-Tcheugui, Justin B.
- Everett, Brendan M.
- Garg, Rajesh
- Laffel, Lori M.
- Lal, Rayhan
- Pandya, Naushira
- Pekas, Elizabeth J.
- Peters, Anne L.
- Pilla, Scott J.
- Romeo, Giulio R.
- Rosas, Sylvia E.
- Segal, Alissa R.
- Szmuilowicz, Emily D.
- ElSayed, Nuha A.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2025-12-08
- Volume
- 49
- Issue
- Supplement_1
- Pages
- S216-S245
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC12690187
- OpenAlex
- W4417121408
- Cited by
- 107
- References
- 298
- Citations by year
- 2026: 107
- FWCI
- 63.21
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- cardiovascular disease, cardiovascular risk management, diabetes mellitus, clinical guidelines, quality of care, treatment goals, level of evidence
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Humans, Risk Management, Societies, Medical, United States, Diabetes Complications, Standard of Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-16, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-16 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
