CONGRESS ABSTRACT

Background Patients with diabetes mellitus represent a heterogeneous population with a wide range of cardiovascular (CV) risk, from primary prevention to advanced atherosclerotic cardiovascular disease (ASCVD). Despite increasing evidence supporting integrated cardio-diabetology models, real-world data on the longitudinal impact of structured care pathways on patient profiling and risk factor control remain limited. We report real-world results of a cardio-diabetology pathway implemented in a tertiary cardiovascular center, with outcomes projected over a 2.5-year observational period. Methods All consecutive patients referred to a dedicated cardio-diabetology outpatient clinic were prospectively evaluated. Demographic characteristics, diabetes type and duration, prevention setting, and cardiometabolic risk factor control were systematically collected. Clinical assessment included age, sex, diabetes type (type 1 vs type 2), diabetes duration (<10 vs ≥10 years), and indication for primary or secondary CV prevention. Risk factor control was assessed by low-density lipoprotein cholesterol (LDL-C <70 vs ≥70 mg/dL) and glycaemic control (HbA1c <7% vs ≥7%). Observed 1-year data were proportionally extrapolated to estimate pathway impact over 2.5 years. Results Over the projected 2.5-year period, approximately 225 patients were managed within the pathway. Most were male (69%) and older than 60 years (65%). Type 2 diabetes accounted for 87% of cases, while 55% had a diabetes duration ≥10 years. Primary prevention represented 63% of patients, whereas 37% had established ASCVD. At follow-up, LDL-C <70 mg/dL was achieved in 45% of patients and HbA1c <7% in 50%. The integrated pathway enabled comprehensive cardiovascular phenotyping, optimization of lipid-lowering and glucose-lowering therapies, and structured follow-up, particularly in older patients and those with long-standing diabetes or ASCVD. Conclusions In a real-world setting, a structured cardio-diabetology pathway allows effective longitudinal management of a large and clinically complex diabetic population. Integrated care supports systematic risk stratification and optimization of cardiometabolic targets in both primary and secondary prevention, confirming cardio-diabetology as a key component of contemporary cardiovascular care.