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Study breakdown

Can Blood Tests and Imaging Help Choose the Best Diabetes Treatment for Heart Protection?

Systematic ReviewModerate evidence
The takeaway

Novel biomarkers like coronary calcium scores and body composition measures may help clinicians personalize diabetes treatment to reduce cardiovascular risk.

2-4x

increased cardiovascular disease risk in type 2 diabetes

What the researchers found

Imaging biomarkers (coronary calcium, cardiac/hepatic steatosis) and circulating biomarkers provide superior cardiovascular risk prediction in T2DM compared to traditional risk assessment tools.

Why it matters

Personalized treatment selection based on biomarkers could help ensure patients receive the diabetes medications most likely to protect their hearts and kidneys.

The numbers in context

No specific thresholds proposed; scoping review of imaging, circulating, and body composition biomarkers.

How the study worked

Scoping review of published literature on novel biomarkers for cardiovascular and renal risk stratification in type 2 diabetes.

Who was studied

Adults with type 2 diabetes

What this study cannot tell us

Scoping review format provides breadth but not the systematic rigor of a full meta-analysis; many biomarkers still need prospective validation in large clinical trials.

How to read the evidence

Scoping review synthesizing existing evidence; individual biomarker studies vary in design and quality.

When this study was published

Published in 2025, reflecting the latest understanding of biomarker-guided diabetes management.

The bigger picture

As GLP-1 receptor agonists and SGLT2 inhibitors prove their cardiovascular benefits, identifying which patients benefit most from each becomes critical for precision medicine in diabetes care.

Questions still open

  • Which specific biomarker combinations offer the best predictive accuracy for treatment selection?
  • Can biomarker-guided therapy selection improve hard cardiovascular outcomes versus standard care?

Common questions

What biomarkers can predict heart risk in diabetes?
Coronary artery calcium scores, liver and heart fat measurements, pericardial fat volume, and various circulating blood markers have shown promise in predicting cardiovascular outcomes better than traditional risk factors.
How could biomarkers change diabetes treatment?
By identifying which patients face the highest cardiovascular or kidney risk, biomarkers could help doctors choose between medications like GLP-1 receptor agonists and SGLT2 inhibitors based on individual patient profiles rather than one-size-fits-all guidelines.

Read the original research

Can Clinical Biomarkers Guide Optimal Therapeutic Selection in Type 2 Diabetes Mellitus? A Scoping Review.

Current atherosclerosis reports, 27(1), 121

Citation

Quinaglia, Thiago; Silva, Gustavo L R; Matos-Souza, Jose Roberto; Coelho-Filho, Otavio Rizzi; Nadruz, Wilson; Sposito, Andrei C. (2025). Can Clinical Biomarkers Guide Optimal Therapeutic Selection in Type 2 Diabetes Mellitus? A Scoping Review.. Current atherosclerosis reports, 27(1), 121. https://doi.org/10.1007/s11883-025-01368-x