Insights into the emerging cardiometabolic prevention and management of diabetes mellitus.
Cardiovascular disease (CVD) and Type 2 diabetes mellitus (DM2), once conceived as different entities, share common origins and pathways. Increased activity of the renin-angiotensin-aldosterone-system, insulin resistance, chronic low-grade inflammation and oxidative stress collectively contribute to endothelial dysfunction and atherosclerosis, which manifest clinically as CVD. Nowadays, it is possible to identify and intervene in high-risk populations even before the clinical diagnosis of DM2. The control of dietary patterns and increased physical activity is completely feasible, as well as the management of hypertension and dyslipidaemia. Pharmacological interventions targeted at blocking renin-angiotensin-aldosterone-system and sensitising to insulin have a role in the prevention of DM2 and CVD, and are avidly explored worldwide. In the near future, ongoing trials should provide data that will allow us to better treat patients with the cardiometabolic syndrome and diabetes in order to reduce CVD morbidity and mortality.
Lastra-Gonzalez
Guido
G
Division of Endocrinology, Harry S Truman VA Medical Center, University of Missouri-Columbia, School of Medicine, MO, USA.
Manrique
Camila Margarita
CM
Govindarajan
Gurushankar
G
Whaley-Connell
Adam
A
Sowers
James R
JR
D000419:Albuminuria / Q000517:prevention & control / Q000628:therapy; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000628:therapy*; D004032:Diet; D004730:Endothelium, Vascular / Q000187:drug effects; D015444:Exercise; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control / Q000628:therapy; D008019:Life Style; D024821:Metabolic Syndrome / Q000517:prevention & control / Q000628:therapy*; D009765:Obesity / Q000517:prevention & control / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D045162:Thiazolidinediones