PHILADELPHIA — At the Heart in Diabetes CME Conference, leading experts presented key findings from four recent studies published in the Journal of the American College of Cardiology. The topics ranged from digital health and nutrition to lifestyle changes and new treatment strategies for diabetic cardiomyopathy.
Trusted Health Tech Still Lacks Solid Evidence
Digital health tools, including artificial intelligence, have great potential to improve cardiometabolic care. However, more real-world evidence is needed before these technologies can be fully integrated into clinical practice.
Robert M. Califf, MD, former FDA commissioner, and Haider J. Warraich, MD, of VA Boston Healthcare System, recently co-authored a paper calling for stronger oversight and validation. Califf noted that, unlike drugs, digital tools don’t require high levels of evidence for approval. Devices only need to show a “reasonable likelihood of safety and efficacy.”
He emphasized that most digital tools, especially those using AI, continue to evolve after entering the market. Therefore, post-market validation in real-world clinical settings is essential.
“This isn’t a technical challenge,” Califf said. “The real issue is our fragmented health care system, which makes it hard to track outcomes and measure effectiveness. Meanwhile, patients are left vulnerable to misinformation.”
Food as Medicine Gains Ground
A growing movement is pushing for nutrition-based interventions to be recognized as part of standard cardiometabolic care. This includes programs like medically tailored meals and produce prescriptions.
Katie Garfield, JD, of Harvard Law School, explained that “Food is Medicine” initiatives aim to treat or prevent disease by integrating nutrition into health care systems. However, these services are not yet standard benefits under federal programs, making funding and access inconsistent.
Garfield and Dariush Mozaffarian, MD, from Tufts University, cited several strategies:
- Meals tailored by registered dietitians
- Pre-selected groceries for patients with specific needs
- Discounts or prescriptions for fresh produce
- Federal screening and support for nutrition programs
- Community-level food access initiatives
Although early results are promising, Garfield stressed the need for broader policy support. “These services are making their way into health care, but often through narrow or optional pathways,” she said.
Lifestyle Changes Show Measurable Heart Benefits
New results from the Look AHEAD ancillary study showed that intensive lifestyle changes can reduce heart disease risk markers in people with type 2 diabetes.
Ambarish Pandey, MD, of UT Southwestern, presented findings showing that a structured weight loss program led to lower levels of high-sensitivity cardiac troponin T, a marker linked to heart disease. Although levels of another marker, NT-proBNP, rose in the short term, the effect faded over four years.
The trial included nearly 4,000 adults with diabetes. Those in the lifestyle group aimed for at least 7% weight loss through diet and exercise, while the comparison group received general support and education.
Researchers found that each increase in NT-proBNP was linked to higher risk for cardiovascular events and heart failure. In contrast, higher troponin T was linked to more cardiovascular events but not heart failure.
“Intensive lifestyle intervention improved cardiac biomarkers and showed long-term benefits, despite a temporary rise in NT-proBNP,” Pandey said.
New Drug Shows Promise for Diabetic Cardiomyopathy
Jose L. Lopez, MD, from the University of Miami, presented phase 3 results from the ARISE-HF trial. The study tested AT-001, an aldose reductase inhibitor, in 691 patients with diabetic cardiomyopathy. The treatment aimed to improve exercise capacity and heart function.
The study also examined differences among racial and ethnic groups. Black and Hispanic participants had poorer baseline heart function and lower activity levels than white participants. They were also less likely to use medications like ACE inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists.
Despite these challenges, treatment with AT-001 led to similar improvements across all groups. Black and Hispanic participants showed better exercise performance and reported higher quality of life scores after treatment.
“There are clear racial and ethnic gaps in treatment and outcomes for diabetic cardiomyopathy,” Lopez said. “But this drug showed benefits across all groups, which is encouraging.”
These findings show growing momentum in the push to combine technology, nutrition, and personalized treatment to improve outcomes for people with diabetes and heart disease.
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