A new study led by UC San Francisco researchers finds that chronic cannabis use, whether it’s smoked or consumed in edible form, is associated with significant cardiovascular risks.
The report, published in JAMA Cardiology, found that people who regularly used marijuana in either form had reduced blood vessel function that was comparable to tobacco smokers. Vascular function in those who used cannabis by either means was reduced roughly by half compared to those who did not use it.
Decreased vascular function is associated with a greater risk of heart attack, hypertension, and other cardiovascular conditions.
The researchers recruited 55 people between October 2021 and August 2024 who were outwardly healthy and either regularly smoked marijuana or consumed edibles containing tetrahydrocannabinol (THC), the primary psychoactive compound found in cannabis.
The participants, none of whom used any form of nicotine, consumed cannabis at least three times a week for at least a year. Smokers averaged 10 years of chronic use, and those who took edibles averaged five years.
Along with decreased vascular function, marijuana smokers had changes in their blood serum that were harmful to endothelial cells, which form the inner lining of all blood and lymphatic vessels. Those who took edibles containing THC, however, did not display these changes in blood serum.
It’s unclear how THC damages blood vessels. But the researchers said it must be happening in a way that does not involve those changes to blood serum.
These results suggest smoking marijuana negatively affects vascular function for different reasons than ingesting THC does, according to first author Leila Mohammadi, MD, PhD, and senior author Matthew L. Springer, PhD.
Despite clinicians recommending that many patients with diabetes take statins, nearly one in five opt to delay treatment. In a new study, researchers from Mass General Brigham found that patients who started statin therapy right away reduced the rate of heart attack and stroke by one third compared to those who chose to delay taking the medication. The results, which can help guide decision-making conversations between clinicians and their patients, are published in the Journal of the American Heart Association.
“I see patients with diabetes on a regular basis, and I recommend statin therapy to everyone who is eligible,” said senior author Alexander Turchin, MD, MS, of the Division of Endocrinology at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system. “Some people refuse because they want to first try lifestyle interventions or other drugs. But other interventions are not as effective at lowering cholesterol as starting statin therapy as soon as possible. Time is of the essence for your heart and brain health.”
Heart attacks and strokes remain the leading cause of complications and mortality for patients with diabetes. Statin therapy reduces risk of these cardiovascular events by preventing plaque buildup in the blood vessels.
The researchers used an artificial intelligence method called Natural Language Processing to gather data from the electronic health records of 7239 patients at Mass General Brigham who ultimately started statin therapy during the nearly 20-year study period. The median patient age was 55, with 51% being women, 57% white, and a median HbA1c of 6.9.
Nearly one-fifth (17.7%) of the patients in the study declined statin therapy when it was first recommended by their clinicians, then later accepted the therapy (after a median of 1.5 years) upon repeated recommendation by their clinician. Of those who delayed, 8.5% had a heart attack or stroke. But for patients who started statins immediately, the rate of those cardiovascular events was just 6.4%.
“Clinicians should recognize the increased cardiovascular risk associated with delaying statin therapy for patients with diabetes and use this information to guide shared decision-making conversations with their patients,” said Turchin.
A new study in the European Heart Journal shows that people who develop type 1 diabetes in adulthood have an increased risk of cardiovascular disease and death, and that those diagnosed later in life do not have a better prognosis than those diagnosed earlier. The study, conducted by researchers at Karolinska Institutet, points to modifiable factors – smoking, poor glucose control and obesity – as the main risk factors.
Type 1 diabetes used to be called childhood diabetes but can start at any time during life – a situation for which there is limited research. The researchers behind the current study wanted to investigate the risk of cardiovascular disease and death in this group, particularly for those diagnosed after the age of 40.
The registry-based study identified 10 184 people diagnosed with type 1 diabetes in adulthood between 2001 and 2020 and compared them to 509 172 matched people in the control group.
The study shows that these people with adult-onset type 1 diabetes had a higher risk of cardiovascular disease and death from all causes, including cancer and infections, compared to the control group.
“The main reasons for the poor prognosis are smoking, overweight/obesity and poor glucose control. We found that they were less likely to use assistive devices, such as insulin pumps,” says first author Yuxia Wei, postdoctoral fellow at the Institute of Environmental Medicine, Karolinska Institutet.
The prognosis can be improved
The results emphasise the seriousness of type 1 diabetes, even when it starts later in life, the researchers say. But the prognosis can improved by avoiding smoking and obesity, especially for those diagnosed later in life.
The researchers plan to continue investigating adult-onset type 1 diabetes, including risk factors for developing the disease and the prognosis of other outcomes, such as microvascular complications. Optimal treatment in adult-onset type 1 diabetes, including the effect of pump use and other advanced technologies, also needs to be explored.
A new study led by researchers at Tulane University suggests that people with hypertension can significantly reduce, and possibly eliminate, their increased risk of premature death by controlling several key health risk factors at once.
The study, appearing in Precision Clinical Medicine, tracked more than 70 000 people with hypertension and over 224 000 without it, using data from the UK Biobank. Researchers followed participants for nearly 14 years to understand how managing these risk factors affected early mortality, defined as dying before age 80.
The eight health risk factors evaluated in the study include: blood pressure, body mass index, waist circumference, LDL “bad” cholesterol, blood sugar, kidney function, smoking status and physical activity. Notably, researchers found that hypertensive patients who had addressed at least four of these risk factors had no greater risk of an early death than those without hypertension.
“Our study shows that controlling blood pressure is not the only way to treat hypertensive patients, because high blood pressure can affect these other factors,” said corresponding author Dr Lu Qi, professor of epidemiology at Tulane University. “By addressing the individual risk factors, we can help prevent early death for those with hypertension.”
Hypertension, defined as a blood pressure of 130mmHg or higher, is the leading preventable risk factor for premature death worldwide.
The study found that addressing each additional risk factor was associated with a 13% lower risk of early death, 12% lower risk of early death due to cancer and 21% lower risk of death due to cardiovascular disease, the leading cause of premature death globally.
“Optimal risk control” – having 7 or more of the risk factors addressed – was linked to 40% less risk of early death, 39% less risk of early death due to cancer and 53% less risk of early death due to cardiovascular disease.
“To our knowledge, this is the first study to explore the association between controlling joint risk factors and premature mortality in patients with hypertension,” Qi said. “Importantly, we found that any hypertension-related excess risk of an early death could be entirely eliminated by addressing these risk factors.”
Only 7% of hypertensive participants in the study had seven or more risk factors under control, highlighting a major opportunity for prevention. Researchers say the findings underscore the importance of personalised, multifaceted care – not just prescribing medication for blood pressure, but addressing a broader range of health behaviours and conditions.
Many observational studies have shown that people who exercise more and have good cardiorespiratory fitness early in life are at lower risk of premature death from causes such as cancer and cardiovascular disease. But a new study published in the European Journal of Preventive Cardiology suggests that the association between physical fitness and a reduced risk of mortality may be misleading.
“We found that people with high fitness levels in late adolescence had a lower risk of dying prematurely, for example from cardiovascular disease, compared to those with low fitness levels. But when we looked at their risk of dying in random accidents, we found an almost similarly strong association. This suggests that people with high and low fitness levels may differ in other important ways, which is something that previous studies have not fully taken into account,” says Marcel Ballin, associated researcher in epidemiology and lead author of the study.
Conscription data from over 1 million men
In the study, the researchers leveraged data from 1.1 million Swedish men who were conscripted for military service between the years 1972 and 1995. The men, who were on average 18 years old at the time of conscription, were divided into five groups based on their fitness level at the time. They were then followed until their 60s or until they died. With access to the National Cause of Death Register, the researchers were able to see their cause of death. They subsequently used different methods to study the association between fitness level in late adolescence and premature death.
The researchers started with a traditional analysis of mortality from cardiovascular disease, cancer and from all causes, as in previous observational studies. They adjusted their statistical models for factors such as BMI, age at conscription, year of conscription, and parents’ income and education level. The results showed that the group with the highest fitness level had a 58% lower risk of dying from cardiovascular disease, a 31% lower risk of dying from cancer, and a 53% lower risk of dying from all causes, compared with the group with the lowest fitness level.
Very similar risk of dying in random accidents
Next, the researchers examined how fitness was associated with the risk of dying in random accidents such as car accidents, drownings and homicides. They chose random accidents because they assumed that there ought to be no association between the men’s fitness in late adolescence and the risk of dying in random accidents. This method is called negative control outcome analysis and involves testing the validity of your results for a primary outcome by comparing them with an outcome where no association ought to be found. If, however, an association is found, it may indicate that the groups studied are not actually comparable, and that the study suffers from what is typically referred to as confounding. The researchers found that men with the highest fitness levels had a 53% lower risk of dying in random accidents. Yet, it is unlikely that the men’s fitness would have such a big effect on their risk of dying in random accidents.
These results were also confirmed when the researchers used the sibling comparison design. Using this method, the researchers compared the risk of premature death between siblings with different fitness levels to control for all the factors that the siblings share such as behaviours, environmental factors, and some genetic factors.
“It surprised us that the association with accidental mortality reflected the other associations, even after we controlled for all the factors that siblings share. This underlines how strong the assumptions are that you make in observational studies, since it appears to be very difficult to create comparable groups. The consequences may be that you overestimate the magnitudes of the effects you find,” says Marcel Ballin.
Picture confirmed in other studies
The study is one of the largest of its kind in which researchers used negative control outcomes to investigate whether the associations between fitness and mortality are in fact valid. The results in this study are also supported by other research.
“That the effects of good cardiorespiratory fitness may be overstated might sound controversial to some, but the fact is that if you look at the results from studies others than traditional observational studies, a more nuanced picture does emerge. A number of twin studies for example have found similar results. Some genetic studies also suggest that there are genes that affect both the propensity to be physically active or have a good fitness level, and the risk of developing diseases such as cardiovascular disease.”
Important to base interventions on correct estimates
Marcel Ballin also argues that there are many different reasons for promoting physical activity. However, large-scale interventions or policy changes intended to apply to the entire population must be based on reliable estimates – otherwise there is a risk of expecting effects that have in fact been overestimated.
“Our results should not be interpreted as if physical activity and exercise are ineffective or that you should not try to promote it. But to create a more nuanced understanding of how big the effects of fitness actually are on different outcomes, we need to use several different methods. If we just ask the question in the same way, we will always get the same answer. It’s only when we get the same answer to a question that we have asked in slightly different ways that we can be sure that the findings are accurate,” says Marcel Ballin.
Even a few nights with insufficient sleep promote molecular mechanisms linked to a greater risk of heart problems. This has been shown in a new study in which the researchers investigated how sleep deprivation affects biomarkers (in this case, proteins) associated with cardiovascular disease. The Uppsala University-led study is published in the journal Biomarker Research.
“Unfortunately, nearly half of all Swedes regularly experience disturbed sleep, and this is particularly common among shift workers. That is why we wanted to try to identify mechanisms that affect how lack of sleep can increase the risk of cardiovascular disease. Ultimately, the purpose was to identify opportunities to address these problems,” says Jonathan Cedernaes, physician and docent at Uppsala University, who led the study.
A chronic lack of sleep is a growing public health problem and in large population studies it has been linked to an increased risk of heart attack, stroke and atrial fibrillation. Heart health is influenced by several lifestyle factors, including sleep, diet and exercise. In order to separate out the effects of sleep, a number of conditions were controlled in the laboratory environment such as diet and physical activity.
How the study was conducted
The authors studied 16 healthy young men of normal weight. They all had healthy sleep habits. The participants spent time in a sleep laboratory where their meals and activity levels were strictly controlled in two sessions. In one session, participants got a normal amount of sleep for three consecutive nights, while during the other session, they got only about four hours of sleep each night. During both sessions, morning and evening blood samples were taken, and following high-intensity exercise lasting 30 minutes.
Inflammatory proteins increased after sleep loss
The researchers measured the levels of around 90 proteins in the blood and were able to see that the levels of many of these that are associated with increased inflammation rose when the participants were sleep-deprived. Many of these proteins have already been linked to an increased risk of cardiovascular disease such as heart failure and coronary artery disease.
“Many of the larger studies that have been done on the link between sleep deprivation and the risk of cardiovascular diseases have generally focused on slightly older individuals who already have an increased risk of such diseases. That is why it was interesting that the levels of these proteins increased in the same way in younger and previously perfectly healthy individuals after only a few nights of sleep deprivation. This means that it’s important to emphasise the importance of sleep for cardiovascular health even early in life,” says Jonathan Cedernaes.
The effects of exercise can be affected by lack of sleep
Physical exercise generated a slightly different response after lack of sleep. However, a number of key proteins increased equally, whether the person was sleep-deprived or not. Thus, proteins that can be linked to the positive effects of exercise increased, even if the person had too little sleep. The researchers have previously shown that exercise in the presence of sleep deprivation can result in a slightly increased load on the heart’s muscle cells.
“With this study, we have improved our understanding of what role the amount of sleep we get plays in cardiovascular health. It’s important to point out that studies have also shown that physical exercise can offset at least some of the negative effects that poor sleep can cause. But it’s also important to note that exercise cannot replace the essential functions of sleep,” says Jonathan Cedernaes.
Hopefully help to develop better guidelines
“Further research is needed to investigate how these effects might differ in women, older individuals, patients with heart disease, or those with different sleep patterns. Our ongoing research will hopefully help to develop better guidelines on how sleep, exercise and other lifestyle factors can be harnessed to better prevent cardiovascular diseases,” says Jonathan Cedernaes.
People who are given a vaccine for shingles have a 23% lower risk of cardiovascular events, including stroke, heart failure, and coronary heart disease, according to a study of more than a million people published in the European Heart Journal.
The protective effect of the vaccine lasts for up to eight years and is particularly pronounced for men, people under the age of 60 and those with unhealthy lifestyles, such as smoking, drinking alcohol and being inactive.
The study was led by Professor Dong Keon Yon from the Kyung Hee University College of Medicine, Seoul, South Korea. He said: “Shingles causes a painful rash and can lead to serious complications, especially in older adults and those with weak immune systems. Previous research shows that, without vaccination, about 30% of people may develop shingles in their lifetime.
“In addition to the rash, shingles has been linked to a higher risk of heart problems, so we wanted to find out if getting vaccinated could lower this risk.”
The study included nearly 1.3 million people aged 50 or older living in South Korea. Researchers gathered data, from 2012 onwards, on whether people received a shingle vaccine and combined this with data on their cardiovascular health and data on other factors that can influence health, such as age, sex, wealth and lifestyle.
The vaccine was a live zoster vaccine, meaning it contained a weakened form of the varicella zoster virus that causes shingles. In many countries, this type of vaccine is now being replaced with a non-live, recombinant vaccine, meaning it contains a protein from the varicella zoster virus.
The study showed that among people who received the vaccine, there was a 23% lower risk of cardiovascular events overall, with a 26% lower risk of major cardiovascular events (a stroke, heart attack or death from heart disease), a 26% lower risk of heart failure and a 22% lower risk of coronary heart disease.
The protective effect was strongest in the two to three years after the shingles vaccine was given, but researchers found that the protection lasted for up to eight years.
Professor Yon said: “Our study suggests that the shingles vaccine may help lower the risk of heart disease, even in people without known risk factors. This means that vaccination could offer health benefits beyond preventing shingles.
“There are several reasons why the shingles vaccine may help reduce heart disease. A shingles infection can cause blood vessel damage, inflammation and clot formation that can lead to heart disease. By preventing shingles, vaccination may lower these risks. Our study found stronger benefits in younger people, probably due to a better immune response, and in men, possibly due to differences in vaccine effectiveness.
“This is one of the largest and most comprehensive studies following a healthy general population over a period of up to 12 years. For the first time, this has allowed us to examine the association between shingles vaccination and 18 different types of cardiovascular disease. We were able to account for various other health conditions, lifestyle factors and socioeconomic status, making our findings more robust.
“However, as this study is based on an Asian cohort, the results may not apply to all populations. Since the live zoster vaccine is not suitable for everyone, more research on the recombinant vaccine is needed. While we conducted rigorous analysis, this study does not establish a direct causal relationship, so potential bias from other underlying factors should be considered.”
Professor Yon and his colleagues also plan to study the impact of the recombinant vaccine to see if it has similar benefits for reducing heart disease.
Four behaviours explain a majority of the socioeconomic disparities observed in the disease
Source: Wikimedia CC0
Lower socioeconomic status is associated with higher rates of death from coronary artery disease compared to higher socioeconomic status, and more than half of the disparities can be explained by four unhealthy behaviours. Dr Yachen Zhu of the Alcohol Research Group, US, and Dr Charlotte Probst of the Centre for Addiction and Mental Health, Canada, report these findings in a new study published September 17th in the open-access journal PLOS Medicine.
Coronary artery disease, also known as coronary heart disease or ischaemic heart disease, occurs when the arteries supplying the heart cannot deliver enough oxygen-rich blood due to plaque buildup, and is a major cause of death in the US. The condition poses a greater risk to people with lower socioeconomic status, but previous studies have reported conflicting results on whether certain unhealthy behaviours, like smoking, are primarily responsible for the observed disparities in deaths from the disease.
In the new study, researchers used data from 524 035 people aged 25 years and older whose mortality statuses were recorded in the National Death Index and who answered the National Health Interview Survey on demographics and health behaviours. The team used education as the primary indicator for socioeconomic status, and investigated four behavioural risk factors: smoking, alcohol use, physical inactivity and BMI. The four factors together explained 74% of the differences in mortality risk from coronary artery disease in men belonging to different socioeconomic levels and 61% in women.
The researchers conclude that their results highlight the need for effective public health policies and interventions that address each of these behaviours – both separately and together – because unhealthy behaviours often cluster among individuals from low socioeconomic backgrounds. They urge public health campaigns to raise awareness about heart health with messaging and outreach efforts customised for male and female audiences. The authors add, “These efforts are crucial to reducing the socioeconomic disparities in deaths from coronary artery disease in the US.”
The demands of the working week, often influenced by school or work schedules, can lead to sleep disruption and deprivation. Fortunately, new research presented at ESC Congress 2024 shows that people that ‘catch up’ on their sleep by sleeping in at weekends may see their risk of heart disease fall by one-fifth.
“Sufficient compensatory sleep is linked to a lower risk of heart disease,” said study co-author Mr Yanjun Song of the State Key Laboratory of Infectious Disease, Fuwai Hospital, National Centre for Cardiovascular Disease, Beijing, China. “The association becomes even more pronounced among individuals who regularly experience inadequate sleep on weekdays.”
It is well known that people who suffer sleep deprivation ‘sleep in’ on days off to mitigate the effects of sleep deprivation. However, there is a lack of research on whether this compensatory sleep helps heart health.
The authors used data from 90 903 subjects involved in the UK Biobank project, and to evaluate the relationship between compensated weekend sleep and heart disease, sleep data was recorded using accelerometers and grouped by quartiles (divided into four approximately equal groups from most compensated sleep to least). Q1 (n = 22 475 was the least compensated, having -16.05 hours to -0.26 hours (ie, having even less sleep); Q2 (n = 22 901) had -0.26 to +0.45 hours; Q3 (n=22 692) had +0.45 to +1.28 hours, and Q4 (n=22 695) had the most compensatory sleep (1.28 to 16.06 hours).
Sleep deprivation was self-reported, with those self-reporting less than 7 hours sleep per night defined as having sleep deprivation. A total of 19 816 (21.8%) of participants were defined as sleep deprived. The rest of the cohort may have experienced occasional inadequate sleep, but on average, their daily hours of sleep did not meet the criteria for sleep deprivation – the authors recognise this a limitation to their data.
Hospitalisation records and cause of death registry information were used to diagnose various cardiac diseases including ischaemic heart disease (IHD), heart failure (HF), atrial fibrillation (AF), and stroke.
With a median follow-up of almost 14 years, participants in the group with the most compensatory sleep (quartile 4) were 19% less likely to develop heart disease than those with the least (quartile 1). In the subgroup of patients with daily sleep deprivation those with the most compensatory sleep had a 20% lower risk of developing heart disease than those with the least. The analysis did not show any differences between men and women.
Co-author Mr Zechen Liu, also of State Key Laboratory of Infectious Disease, Fuwai Hospital, National Centre for Cardiovascular Disease, Beijing, China, added: “Our results show that for the significant proportion of the population in modern society that suffers from sleep deprivation, those who have the most ‘catch-up’ sleep at weekends have significantly lower rates of heart disease than those with the least.”
South Africa has seen the quickest and most alarming rise of diabetes on the continent; from an estimated 1.9 million people living with the condition in 2011 to 4.2 million by 2021 – with 7.5 million predicted to be afflicted by 20451. South Africa also has the fastest rising prevalence on the continent with an estimated 20% of the adult population either diabetic or pre-diabetic1. Globally, diabetes prevalence is predicted to rise by 46% between 2019 and 20452. It currently stands at some 537 million people worldwide1.
This emerged at the recently held annual Sanofi medical meeting, the Cardio-Metabolic Axis Forum from April 19th–21st in Cape Town. This was a meeting of leading endocrinologists, specialist physicians, nephrologists, diabetes-treating doctors, academics and Patient Advocacy Groups (PAGs).
Speaking at the conference, specialist physician and endocrinologist, Dr Landi Lombard – former editor of the South Africa Journal of Diabetes and Vascular Disease – told delegates that the risk of death associated with diabetes in cardiovascular conditions is more than twice that of people with non-diabetes, while in all-cause mortality, it’s just under twice that of a person living without diabetes. Of the estimated 537 million people living with diabetes globally, only about half are diagnosed, of whom 25% receive care, 12.5% achieve treatment targets, and 6% live a life free of diabetes-related complications1.
Dr Lombard said that the pandemic is being driven by poor lifestyle choices and diet, lack of exercise and widespread obesity in the population, so better healthcare worker communication and education of patients is vital to stem the tide of diabetes.
Professor Robert Ritzel of the Department of Endocrinology, Diabetology and Angiology at Schwabing Hospital in Munich, said the Pacific Islands and the Middle East led the world with diabetes prevalence at between 25 % and 40 %. He said what precipitated a surge in diabetes was the speed at which a nation changed from a traditional to a modern lifestyle. When this happened within a few years, diabetes prevalence was likely to range between 20% and 40%. However, when change occurred over many generations, it gave epidemiologists and clinicians time to adapt.
Lombard said one of the biggest challenges was what diabetologists called ‘therapeutic inertia’ which contributes to a patient living with sub-optimal blood sugar control for many years. This term embraced physician, patient and healthcare system factors, patient injection related factors, time and resource constraints among physicians and the lack of a proper healthcare system plan. He said that in people with Type 2 diabetes, the median time it takes for the disease to intensify while taking one or more anti-diabetic drugs is 2.9 years. However, the use of an injectable slowed intensification down to 7.2 years or more.
Reasons for failure to intensify treatment or progress to injectable therapies varied between specialist and primary care physicians but were mainly because of a patient fear of injection, too many injections, perceptions of this being a ‘last resort’ treatment, fear of weight gain, fear of low blood sugar, and poor communication with patients.
Lombard said even 1 year of poor blood sugar control in people with Type 2 diabetes could result in an increase in the cumulative incidence of kidney disease of 18%, neuropathy of 8%, retinopathy of 7% and a significantly increased risk of heart attack (67%), heart failure (64%), stroke (51%) and composite cardiovascular events (62%).
Professor Naomi ‘Dinky’ Levitt, former Head of Endocrinology and Diabetic Medicine at the University of Cape Town and Groote Schuur Hospital and Director of the Chronic Disease Initiative for Africa, highlighted gestational diabetes as one of the greatest challenges.
Described as the “doyenne” of endocrinology in South Africa (SA), Levitt said one third of women who have gestational diabetes go on to develop diabetes within 6 years of giving birth, so post-partum intervention is crucial.
According to Levitt, lifestyle interventions had about a 20% positive effect, mainly because new mothers were pulled in all directions by family, the baby, husband, and domestic and work needs.
She said that with 31.4% of SA women estimated to have developed gestational diabetes, it would be ideal to screen all pregnant women at 24 and 28 weeks. However, this would collapse the healthcare system because of the healthcare staffing demands, so the alternative was to focus on risk factors such as being over 30 years old or being overweight.
She said that focusing on women with gestational diabetes would have the greatest impact on the pandemic, as treatment can help avoid pre-eclampsia and improve foetal development, resulting in fewer admissions to the neonatal ICU.
Speaking on behalf of Sanofi the conference sponsor, Dr Asafika Mbangata said: “Sanofi puts patients first and the aim of the conference was to empower stakeholders with the right information to help make critical care decisions for patients by sharing the latest data on advancements in treatments and technologies, along with insights into global and local policy changes impacting diabetes care.”
“As we chase the miracles of science to improve people’s lives, we know we cannot shape the future of diabetes management without partnerships with healthcare professionals and other stakeholders. Collaboration across all medical disciplines is essential if we are to overcome this pandemic, and we’re hopeful the conference opened the door to future robust collaborative actions that improve patient outcomes,” concluded Dr Mbangata.
References
Adapted from IDF Diabetes Atlas (10th edition). International Diabetes Federation. 2022. http://www.diabetesatlas.org/. Accessed 23 April, 2024.
