Ibero-American position statement on therapeutic recommendations for the preventive management of cardiovascular complications in latin-American patients with type 2 diabetes mellitus: consensus of the prevention council of the inter-American society of cardiology (SIAC-PREVENT)
Abstract
BACKGROUND: Type 2 diabetes mellitus (T2DM) affects an estimated 463 million adults worldwide, nearly 80% of whom live in low- and middle-income countries. Latin America and the Caribbean (LAC) are among the regions with the fastest-growing T2DM prevalence, with ~ 32 million affected individuals- Against this background, the SIAC Prevention Council (SIAC-PREVENT) developed regionally adapted, equity-oriented recommendations for the preventive management of cardiovascular complications in T2DM. METHODS: We convened a multidisciplinary panel from across LAC and followed AGREE II and RIGHT principles. A comprehensive search (MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, SciELO, LILACS, and grey literature) from 2010 to 2025. Risk of bias was assessed using RoB 2, ROBINS-I, and AMSTAR 2; certainty of evidence was graded with GRADE. Draft recommendations were iteratively reviewed and validated in virtual meetings and an in-person consensus conference, with recorded voting procedures. FINDINGS: In LAC, T2DM prevalence reaches 13–14% in some countries, with high disability burden. Over 80% of patients are overweight or obese; MASLD and peripheral arterial disease are common. T2DM confers a 2–4-fold increased cardiovascular risk and higher rates of stroke and heart failure. The Council proposes an integrated, risk-based strategy combining: systematic cardiovascular risk stratification; early obesity management; a four-pillar cardiorenal approach (RAS blockade, SGLT2…
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