What is Cardiometabolic Disease (CMD)?
Cardiometabolic Disease Overview
Cardiometabolic disease (CMD) is a long-term, progressive health condition that can lead to both metabolic problems like diabetes and vascular problems like heart disease (2, 3). At the core of CMD is insulin resistance. Insulin resistance occurs when your body’s cells don’t respond well to insulin (2, 3). This doesn’t just affect blood sugar levels but also leads to a range of other issues like inflammation, stiff blood vessels, and poor cell function. These problems cause signs and symptoms such as high blood pressure, unhealthy cholesterol levels, higher blood sugar levels, and fat build-up in the liver and around the belly (2, 3).
Early Signs and Risk of Cardiometabolic Disease (CMD)
CMD starts silently and may not show clear symptoms for many years. Over time, as it progresses, people might develop signs like prediabetes, high triglycerides, low HDL (good) cholesterol, fat accumulation around the abdomen, and high blood pressure (2). When one or more of these signs are evident, this is an indication that you may be insulin resistant and at risk for more serious conditions like type 2 diabetes (T2D) and heart disease (2). Insulin resistance speeds up the process of artery damage, leading to heart attacks, strokes, and poor circulation in the legs (2). Insulin resistance can also lead to fatty liver disease. Additionally, it can affect the heart muscle, leading to heart failure and irregular heartbeats. Kidney function can also decline, which worsens heart problems (2).
Warning Signs of Cardiometabolic Disease (CMD)
Obesity makes insulin resistance worse and pushes CMD towards more serious metabolic and vascular health issues (2, 3). Warning signs such as persistently elevated blood pressure, unhealthy cholesterol and triglyceride levels, above-normal blood sugar, and increased abdominal fat are key indicators that CMD is present and that there is risk that things may progress to diabetes and cardiovascular disease (2). In particular signs that CMD has already progressed to diabetes include fatigue, unexplained weight changes, persistent thirst or frequent urination. If you notice any of these warning signs, it’s important to contact your healthcare provider.
Managing and Treating Cardiometabolic Disease (CMD)
Understanding how CMD works is important for treatment. When signs of CMD appear, it’s important to take steps to prevent the disease from getting worse through healthy lifestyle changes and managing risk factors with the guidance of a healthcare professional. Structured programs combining caloric restriction and increased physical activity are key to weight management (12). Regular exercise and diets like the Mediterranean diet have been shown to slow the progression of CMD (refer to the “What Can You Do to Lower the Risk of Diabetes and Cardiovascular Disease?” section for more detailed information). Weight loss is a key part of managing CMD because it can reduce many risk factors and prevent serious outcomes; however, behavioral interventions and social support networks (such as peer groups or counseling programs) help patients sustain healthy changes (12). In summary, managing CMD involves a combination of lifestyle changes, medications, and sometimes surgery to address both metabolic and vascular problems (2, 3, 5).
Why can the Cardiometabolic Disease Staging (CMDS) System Help?
The Cardiometabolic Disease Staging (CMDS) system was developed to measure the severity of CMD. It uses various health factors, like blood pressure, glucose level, and cholesterol levels, in a formula to predict the risk of developing type 2 diabetes and/or heart disease over the next 10 years of your life (4). This score helps doctors understand how serious CMD is for each person and guides them in making treatment decisions.
Insulin Resistance
What is Insulin Resistance, and How Does It Produce Both Metabolic and Vascular Diseases?
Insulin resistance happens when your body's cells don't respond well to insulin, the hormone that helps sugar enter your cells. When cells become resistant, the body must produce more insulin to keep blood sugar levels regular. Over time, this can lead to high blood sugar, which might develop into diabetes (2). Insulin resistance is also associated with inflammation throughout the body and contributes to the buildup of fatty plaques in blood vessels, increasing the risk of heart disease (2). The condition can start years before any symptoms appear, slowly causing damage that can lead to serious health problems like heart attacks, strokes, and poor circulation (2). These complications collectively arise from the chronic inflammatory state of CMD, with insulin resistance as the primary trigger (2, 4).
Informing Management of Insulin Resistance and Cardiometabolic Disease (CMD) with the Cardiometabolic Disease Staging (CMDS) Tool
The CMDS tool can accurately quantify the severity of CMD as a consequence of insulin resistance, providing you or your doctor with essential guidance for management and prevention. By managing your diet, staying active, self-monitoring, managing your stress, and taking medications when needed, you can help reduce insulin resistance and lower your risk of developing metabolic and vascular diseases due to CMD (2, 4, 5, 12, 14).
