Impact of data from recent clinical trials on strategies for treating patients with type 2 diabetes mellitus.
Type 2 diabetes is associated with increased risk for the development of cardiovascular disease (CVD) secondary to hyperglycemia's toxicity to blood vessels. The escalating incidence of CVD among patients with type 2 diabetes has prompted research into how lowering glycated hemoglobin (HbA(1c)) may improve CVD-related morbidity and mortality. Data from recent studies have shown that some patients with type 2 diabetes actually have increased mortality after achieving the lowest possible HbA(1c) using intensive antidiabetes treatment. Multiple factors, such as baseline HbA(1c), duration of diabetes, pancreatic beta-cell decline, presence of overweight/obesity, and the pharmacologic durability of antidiabetes medications influence diabetes treatment plans and therapeutic results. Hypertension and dyslipidemia are common comorbidities in patients with type 2 diabetes, which impact the risk of CVD independently of glycemic control. Consideration of all of these risk factors provides the best option for reducing morbidity and mortality in patients with type 2 diabetes. Based on the results of recent trials, the appropriate use of current antidiabetes therapies can optimize glycemic control, but use of intensive glucose-lowering therapy will need to be tailored to individual patient needs and risks.
Palumbo
Pasquale J
PJ
Department of Endocrinology, Mayo Clinic College of Medicine, Scottsdale, AZ, USA. palumbo.pasquale@mayo.edu
Wert
Jonathan M
JM
D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D003925:Diabetic Angiopathies / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D004359:Drug Therapy, Combination / Q000379:methods; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000150:complications
D006442:Glycated Hemoglobin