People with FH and type 2 diabetes are doubly disadvantaged

Adriaan Kooy is an internist and vascular physician at Treant, an umbrella organization for hospitals in Drenthe, and also an associate professor at the University Medical Center Groningen. Now that Treant is a LEEFH center, care for people with familial hypercholesterolemia (FH) in the north of the country can save even more lives, according to the physician and researcher.

Treant is an umbrella organization for hospitals in Hoogeveen, Stadskanaal, and Emmen. Since the summer of 2024, Treant has been authorized to call itself a LEEFH center. Dr. Adriaan Kooy is a vascular physician here. He is also an associate professor of medicine at the UMCG and a researcher. In short, he is deeply committed to the diagnosis, treatment, and prevention of vascular disorders. As is the case with FH. "At Treant, which also includes our Bethesda Diabetes Research Center, our mission is to reduce the risk of cardiovascular disease in highly vulnerable, genetically predisposed groups," he explains. "Medication and lifestyle changes often go hand in hand. For people with hereditary high cholesterol, a healthy lifestyle alone is not enough. They have a defect in their DNA that causes their cholesterol to be so high. Part of caring for them involves identifying new patients; people who have FH without knowing it. That is life-threatening. And what about the increasingly common dangerous combination of type 2 diabetes and FH? With medication and lifestyle changes, serious cardiovascular disease can be successfully prevented in these very high-risk groups. Treant is located in the northern Netherlands. Certainly in this region, not all people with FH have been identified yet. We would like to contribute to this. We are therefore very pleased that we are now a LEEFH center, so that we can make use of the existing FH care network.

Type 2 diabetes

As a researcher, Adriaan Kooy is also interested in FH. "In this group, additional diagnoses such as type 2 diabetes can increase the risk of cardiovascular disease, in addition to the genetic predisposition that people with FH already have. FH and type 2 diabetes together result in a very serious increased risk of cardiovascular disease. In my research, I focus on what is the best treatment for the group that is doubly disadvantaged with FH and type 2 diabetes." This concerns health gains that really matter, from which people with FH immediately benefit. "If you have both conditions, you may need to be treated differently, not only to prevent cardiovascular disease, but also dementia and cancer, for example. The mechanisms underlying this are becoming increasingly clear. We want to get a clear picture of this 'composite risk group', because prediabetes and type 2 diabetes make the already elevated cholesterol in FH even more toxic. This warrants additional research and treatment so that we can see what works, enabling people with a complex risk profile to benefit quickly. Ultimately, that is what the treatment of FH with possible diabetes is all about. As a doctor, you want to and can help prevent an enormous disease burden for individuals and society in this case."

Premature death

One of the advantages of a LEEFH center is not only that people with FH are treated according to the latest scientific developments, but also that people with FH are actively screened, according to Adriaan Kooy. "That makes the treatment of FH special. We don't just look at people who have already been diagnosed, but also at those who don't know yet and may be surprised by premature death. If you have FH, it's useful to know, because good treatment pays off. Not just for yourself, but also for your children. If children have FH, they can be given medication from the age of eight to prevent them from becoming ill. What's more, complex risk groups deserve targeted information. A LEEFH center of expertise can provide all this advice based on the latest insights and sound research."