SHIELD

Context: More than a metabolic disease, diabetes is an important cardiovascular risk factor with a very adverse prognostic impact. Throughout its natural history, it is important to simultaneously optimize antibiotic and cardioprotective therapy and identify and control all cardiovascular risk factors. When diagnosing diabetes, starting cardioprotective antidiabetic therapy is vital to ensure the best possible prognosis.

Virtual Scenario: Mr. Joshua has been struggling to stop smoking for over 10 years and has also a past medical history of hypertension and dyslipidemia.

Context: More than a metabolic disease, diabetes is an important cardiovascular risk factor with a very adverse prognostic impact. Throughout its natural history, it is important to simultaneously optimize antibiotic and cardioprotective therapy and identify and control all cardiovascular risk factors. When monotherapy is not enough, it is important to choose the best cardioprotective antidiabetic therapy.

Virtual Scenario: Ms. Voight has a medical history of type 2 diabetes, hypertension, and dyslipidemia.

Context: More than a metabolic disease, diabetes is an important cardiovascular risk factor with a very adverse prognostic impact. Throughout its natural history, it is important to simultaneously optimize antibiotic and cardioprotective therapy and identify and control all cardiovascular risk factors. When dual therapy is not enough, it is important to reinforce it with the best cardioprotective antidiabetic therapy.

Virtual Scenario: Mr. Godier was diagnosed with diabetes eight years ago. Since then, he is regularly visiting a doctor to check his health.

Context: More than a metabolic disease, diabetes is an important cardiovascular risk factor with a very adverse prognostic impact. Throughout its natural history, it is important to simultaneously optimize antibiotic and cardioprotective therapy and identify and control all cardiovascular risk factors. Even in patients already insulin-treated, whenever metabolic control is not perfect, it makes sense to consider a reinforcement of oral cardioprotective therapy.

Virtual Scenario: Mrs. Hudson is retired and loves to take care of her grandchildren during the week. She has had diabetes for over 11 years but she has never managed to control her sugar levels. Additionally, she has hypertension and dyslipidemia.

Context: The new ESC guidelines represent a change of paradigm in the treatment of heart failure, which now has four pillars regarding drug therapy. In each heart failure patient, our goal is now to introduce these four drugs in the optimal doses as soon as possible to improve patient prognosis. This means adding a SGLT2 inhibitor in all patients eligible.

Virtual Scenario: Mr. Liu has recently retired from his job. He has been losing his energy with small efforts at home, going up and down the stairs. He has also a medical history of alcoholism and smoking.

Context: The new ESC guidelines represent a change of paradigm in the treatment of heart failure, which now has four pillars regarding drug therapy. In each heart failure patient, our goal is now to introduce these four drugs in the optimal doses as soon as possible to improve patient prognosis. In many heart failure patients, conventional therapy will not be enough, thus requiring new optimal therapy.

Virtual Scenario: Ms. Wilkins hasn’t been feeling well lately. Daily tasks seem to leave her without any energy, even before completing them. A family member recommended she see a doctor, which is why she is here at the clinic.

Context: The new ESC guidelines represent a change of paradigm in the treatment of heart failure, which now has four pillars regarding drug therapy. In each heart failure patient, our goal is now to introduce these four drugs in the optimal doses as soon as possible to improve patient prognosis. In many heart failure patients, triple therapy will not be enough, thus requiring the fourth pillar.

Virtual Scenario: Mr. Reed really enjoys socializing with his friends. He has dinner with his friends every week, but at his last dinner, his colleagues noticed that he felt very tired and with shortness of breath when he made small efforts. They talked to him and he made a routine appointment.

Context: Recent studies promote a change of paradigm in the treatment of kidney failure, which now has three pillars regarding drug therapy. In each kidney failure patient, our goal is now to introduce these drugs in the optimal doses as soon as possible to improve patient prognosis. It should be done as soon as a diagnosis of kidney failure is done.

Virtual Scenario: Mr. Akiyama was progressively urinating less during the past couple of years. At first, he didn’t notice anything odd with the frequency he went to the bathroom. However, as this situation progressed, he couldn’t ignore the problem anymore and scheduled a visit at the clinic.

Context: Recent studies promote a change of paradigm in the treatment of kidney failure, which now has three pillars regarding drug therapy. In each kidney failure patient, our goal is now to introduce these drugs in the optimal doses as soon as possible to improve patient prognosis. One of these drugs can be used not only for kidney protection but also for cardiovascular and metabolic optimization

Virtual Scenario: Ms. Kamau has had diabetes for several years. Unfortunately, she has not paid much attention to the doctor’s advice, which has not helped control her blood glucose levels. Lately, she has been feeling ill and decided to see her doctor.

Context: Recent studies promote a change of paradigm in the treatment of kidney failure, which now has three pillars regarding drug therapy. In each kidney failure patient, our goal is now to introduce these drugs in the optimal doses as soon as possible to improve patient prognosis. In patients using only classical therapy, the adding of a third drug can vastly improve kidney function and patient prognosis.

Virtual Scenario: Mr. Alexandersson is a senior with a tendency for high blood pressure. He has felt that his health is not as robust as it used to be, so he reluctantly accepted his wife’s insistence to see a doctor.