Masters of Medicine Conference
Why diabetes is a cardiovascular disease
Rethinking risk, weight and long-term outcomes
Published:Wednesday | January 21, 2026 | 12:07 AM
At the Masters of Medicine Medical Conference: The Weight of the Matter: Redefining Health and the Heart, held January 16 to18, 2026, at the AC Marriott Hotel in Kingston, leading clinicians and researchers from around the world gathered to confront some of the most pressing challenges in cardiometabolic health.
Among the distinguished speakers was Dr Marietta Ambrose, Associate Professor of Medicine at the University of Pennsylvania, who delivered a compelling presentation on why diabetes should be viewed fundamentally as a cardiovascular disease, and what that means for prevention, treatment, and population health in Jamaica and the wider Caribbean.
“In clinical reality, diabetes is not just a disorder of glucose metabolism. It is a cardiovascular disease in its own right, because the vascular damage caused by chronic hyperglycaemia directly accelerates atherosclerosis, impairs microvascular function, and increases the risk of coronary artery disease, stroke, and heart failure,” Dr Ambrose said.
Globally, the link between diabetes and heart disease is well established. People with type 2 diabetes are four times more likely to have a heart attack or stroke than individuals without diabetes, and an estimated one in three people with type 2 diabetes also have cardiovascular disease.
In Jamaica, diabetes affects approximately 11 to 12.5 per cent of adults, and rates have increased significantly over recent decades. Across the Caribbean region, adult diabetes prevalence is similarly high, estimated at around 9 percent region-wide, and rising alongside obesity and other metabolic risk factors.
EVIDENCE-BASED APPROACHES
These conditions do not exist in isolation. In Jamaica, hypertension affects up to 30 to 50percent of adults, and obesity rates remain alarmingly high, more than 60 percent for women and 40 percent for men, creating a perfect storm for cardiometabolic disease. In diabetic patients, the combination of high blood sugar, elevated blood pressure, and lipid abnormalities accelerates vascular damage and increases risk for major events such as myocardial infarction and stroke.
“Understanding diabetes as a cardiovascular disease fundamentally shifts the clinical and public health focus toward early prevention and rigorous risk factor management,” Dr. Ambrose said.
Dr Ambrose highlighted the importance of glycaemic control, not only to reduce microvascular complications like retinopathy and nephropathy, but also to reshape cardiovascular outcomes.
“Evidence shows that sustained control of blood glucose, even when modest, reduces the risk of macrovascular events. Intensive glycemic management, alongside aggressive control of blood pressure and cholesterol, forms the backbone of reducing heart attack, stroke, and heart failure risk in patients with diabetes.
She stressed the role of HbA1c levels, a measure of average blood glucose over time, as a key target in clinical management and a predictor of long-term cardiovascular outcomes.
Addressing obesity was a central component of Dr. Ambrose’s session. “Effective, durable weight loss is one of the most powerful tools we have to alter the trajectory of both diabetes and heart disease,” she said.
Dr. Ambrose discussed several evidence-based approaches:
• Medical nutrition therapy and lifestyle modification, focusing on sustainable eating patterns and increased physical activity.
• Pharmacologic therapies such as GLP-1 receptor agonists, which have shown benefits in both glycaemic control and cardiovascular risk reduction.
• Bariatric surgery for eligible patients, which has proven to deliver significant and sustained weight loss with improvements in diabetes and cardiovascular outcomes.
SIDE EFFECTS AND LIMITATIONS
No treatment is without risks, and Dr Ambrose was careful to discuss the potential side effects and limitations of advanced therapies. Pharmacologic agents, while effective, may cause gastrointestinal discomfort or rare but serious complications.
Bariatric procedures, though transformative for many, carry surgical risks and require long-term lifestyle changes and monitoring. Intensive glycaemic lowering can sometimes increase the risk of hypoglycaemia if not carefully managed, underscoring the importance of individualized care plans.
Given the high community prevalence of diabetes and cardiovascular risk factors, Dr. Ambrose called for integrated strategies that marry clinical intervention with public health action.
“Community-wide efforts to reduce obesity, improve diet quality, and increase physical activity, in concert with clinical management, will determine whether we turn the tide on diabetes and cardiovascular disease in our region,” she said.
Her remarks came during a session that underscored the crossover between chronic disease, health systems resilience, and preventive cardiology, themes central to the 2026 Masters of Medicine Conference, which also addressed challenges such as climate-related impacts on health infrastructure and care delivery.