Does treatment of noninsulin-dependent diabetes mellitus reduce the risk of coronary heart disease?
Diabetes is an independent risk factor for the development of coronary heart disease and has a tremendous impact on mortality. In patients with noninsulin-dependent diabetes mellitus, coronary heart disease is the leading cause of death. Both hyperinsulinemia and hyperglycemia have been suggested as risk factors for accelerated atherogenesis in diabetes. Whichever mechanism is implicated, a beneficial effect of therapy in preventing cardiovascular disease is a major requirement. Until now, it is not clear whether stringent control of blood glucose levels reduces the risk of development of coronary heart disease in patients with noninsulin-dependent diabetes mellitus. This review emphasizes the relative roles of insulin and glucose on coronary heart disease development in noninsulin-dependent diabetes mellitus. The different therapeutic options of pharmacological treatment in hyperglycemia in noninsulin-dependent diabetes mellitus are discussed, as well as their impact on coronary heart disease risk.
Giugliano
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Department of Geniatrics and Metabolic Diseases, Second University of Naples, Italy.
D003327:Coronary Disease / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D006946:Hyperinsulinism / Q000150:complications; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; D008687:Metformin; D005947:Glucose