Impact of multidisciplinary cardiometabolic clinics on cardiovascular risk management and therapeutic optimization in patients with type 2 diabetes mellitus

Abstract Background/Information Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease (CVD), contributing significantly to morbidity and mortality. Recent evidence highlights the role of multidisciplinary cardiometabolic outpatient clinics in improving patient outcomes through comprehensive risk factor management, integration of novel therapeutic strategies and individualized treatment plans. However, real-world data on their impact remain limited. Purpose This study aimed to evaluate the effectiveness of multidisciplinary cardiometabolic clinics in optimizing cardiometabolic risk factors, prescribing guideline-directed medical therapies (GDMT) and improving clinical outcomes in patients with T2DM and high cardiovascular risk. Methods A prospective cohort study was conducted in two tertiary university hospitals in Greece, where 200 outpatients with T2DM were enrolled. Patients underwent a structured clinical evaluation by both diabetologists and cardiologists, including cardiovascular risk assessment, lifestyle counselling and optimization of pharmacological treatment according to European Society of Cardiology (ESC) guidelines. Baseline and follow-up measurements (median follow-up: 5 months) were recorded. Results At baseline, 76% of the patients were males, with a mean age of 62±10 years and a median T2DM duration of 6.5 years. Hypertension (75%), dyslipidemia (79%) and coronary artery disease (CAD) (45%) were highly prevalent. Only 21% of very high-risk patients had LDL cholesterol levels below the recommended 55 mg/dL threshold. Following cardiometabolic clinic intervention (Figure 1), significant improvements were observed in key metabolic parameters: HbA1c: Decreased from 7.85±1.73% to 6.86±1.05% (p0.001); LDL cholesterol: Reduced from 86.7±33.3 mg/dL to 60.4±28.6 mg/dL (p0.001); BMI: Improved from 33.3±6.2 to 32.1±6.05 kg/m² (p0.001); Fasting glucose: Reduced from 143.4±47.1 mg/dL to 128.8±38 mg/dL (p=0.003) (Figure 2). Therapeutic optimization resulted in increased GDMT prescriptions: GLP-1 receptor agonists: Increased from 27% to 71.5% (p0.001); SGLT2 inhibitors: Increased from 31% to 56% (p0.001). Statins: Increased from 75% to 85.5% (p0.001), with 54% of high-risk patients achieving LDL cholesterol 55 mg/dL; Ezetimibe use: Increased from 24% to 46.5% (p0.001). In addition, 31% of patients were diagnosed with previously unrecognized CAD, 13% with heart failure, and 8% with peripheral artery disease, emphasizing the role of comprehensive screening. Conclusion Multidisciplinary cardiometabolic outpatient clinics significantly improve cardiovascular risk factor control, adherence to guideline-recommended therapies, and facilitate early detection of cardiovascular complications in patients with T2DM. These findings support the integration of specialized, team-based care models to enhance the management of high-risk cardiometabolic patients, reduce healthcare fragmentation, and improve long-term outcomes.