Dr Yehuda Handelsman: DCRM Guidelines Are Shaping Integrated, Global CRM Care

In part 2 of our interview with Yehuda Handelsman, MD, medical director and principal investigator at the Metabolic Institute of America, he explained that cardiorenalmetabolic (CRM) disease management is progressing toward a more integrated and practical approach after the 2022 Diabetes, Cardiorenal, and Metabolic (DCRM) multispecialty practice recommendations and the recently updated DCRM 2.0 guidelines helped to simplify care, promote global collaboration, and highlight the importance of early, comprehensive management for patients with multiple comorbidities.

He expands upon this topic in part 1 of the interview and his report, “Diabetes, Cardiorenal, and Metabolic Multispecialty Practice Recommendations and Early Intensive Management of Cardio-Renal-Metabolic Disease,” featured in the December 2024 American Journal of Managed Care® supplement, “Optimal Management of Patients With Cardio-Kidney-Metabolic Syndrome.”

This transcript has been lightly edited for clarity.

Transcript

Looking ahead, how do you see CRM disease management evolving? In your opinion, what role will the DCRM recommendations play in shaping these changes?

I think the recognition will come forward. Recently, the American Heart Association came up with a presidential statement or consensus on cardiovascular-kidney-metabolic health, so CKM, still a very good construct. Professional-like, more CRM, I think CKM may be a good language for patient care. Cardio-kidney vs cardio-renal, it doesn't matter, the knowledge of the conditions has become much more prevailed, so I think more people will come up with recommendations as we did; our recommendation is practical.

The original DCRM has reached more than a million people internationally. We have networks of primary care physicians and specialists using the DCRM because it makes it easy for them. In some cases, it's part of their networks. We know that networks in India that is connected to networks in New Mexico and Houston have been using it. I, myself, have given lectures in anywhere from places in Europe to Egypt, China, the Philippines, and India. People like this concept, and I know that it's been shown by many experts, a lot of them not involved with our group, but they found it very helpful.

Right now, I'm getting requests from all over the world to send it [DCRM recommendations], and it's available for free. What they [experts] say is that maybe our need is to create guidelines and practice accommodations in a simple way so people don't need to read a textbook and can look directly at how we can simply help patients. We will try to incorporate it into EMRs [electronic medical records] to make it much easier, both through diagnosis and management, and for people to recognize that the more conditions that a DCRM patient has, the more complications or comorbidities, the higher the risk they have to die, the higher the risk they have to get to an end-stage disease of one type or another. So, the urgency to manage them earlier and with different drugs in different classes and combinations is very important. So, hopefully, that urgency will come.

I have a comment for leadership from the different medical societies, that they will also find ways to come together. So like we, as individuals, most of us leaders in different medical societies, together we came. Hopefully, the medical societies can perhaps do something similar and give equal footing to kidney, heart, liver, diabetes, blood pressure, and obesity and not necessarily what's important to one medical society or another. So, let's work together for the patient's benefit.