Early intervention and intensive management of patients with diabetes, cardiorenal, and metabolic diseases

Yehuda Handelsman, Javed Butler, George L. Bakris, Ralph A. DeFronzo, Gregg C. Fonarow, Jennifer B. Green, George Grunberger, James L. Januzzi, Samuel Klein, Pamela R. Kushner, Darren K. McGuire, Erin D. Michos, Javier Morales, Richard E. Pratley, Matthew R. Weir, Eugene Wright, Vivian A. Fonseca

Research output: Contribution to journalReview articlepeer-review


Increasing rates of obesity and diabetes have driven corresponding increases in related cardiorenal and metabolic diseases. In many patients, these conditions occur together, further increasing morbidity and mortality risks to the individual. Yet all too often, the risk factors for these disorders are not addressed promptly in clinical practice, leading to irreversible pathologic progression. To address this gap, we convened a Task Force of experts in cardiology, nephrology, endocrinology, and primary care to develop recommendations for early identification and intervention in obesity, diabetes, and other cardiorenal and metabolic diseases. The recommendations include screening and diagnosis, early interventions with lifestyle, and when and how to implement medical therapies. These recommendations are organized into primary and secondary prevention along the continuum from obesity through the metabolic syndrome, prediabetes, diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease (NAFLD), atherosclerotic cardiovascular disease (ASCVD) and atrial fibrillation, chronic kidney disease (CKD), and heart failure (HF). The goal of early and intensive intervention is primary prevention of comorbidities or secondary prevention to decrease further worsening of disease and reduce morbidity and mortality. These efforts will reduce clinical inertia and may improve patients' well-being and adherence.

Original languageEnglish (US)
Article number108389
JournalJournal of Diabetes and its Complications
Issue number2
StatePublished - Feb 2023


  • Cardiovascular disease
  • Chronic kidney disease
  • Diabetes
  • Heart failure
  • Obesity

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


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