Diabetes and cardiovascular disease: changing the focus from glycemic control to improving long-term survival.
Diabetes mellitus (DM) is the fifth-leading cause of death worldwide and contributes to leading causes of death, cancer and cardiovascular disease, including CAD, stroke, peripheral vascular disease, and other vascular disease. While glycemic management remains a cornerstone of DM care, the co-management of hypertension, atherosclerosis, cardiovascular risk reduction, and prevention of long-term consequences associated with DM are now well recognized as essential to improve long-term survival. Clinical trial evidence substantiates the importance of glycemic control, low-density cholesterol-lowering therapy, blood pressure lowering, control of albuminuria, and comprehensive approaches targeting multiple risk factors to reduce cardiovascular risk. This article presents a review of the role of DM in the pathogenesis of atherosclerosis and cardiac dysfunction, recent evidence on the degree of glycemic control and mortality, and available evidence for a multifaceted approach to improve long-term outcomes for patients.
University of Colorado Anschutz Medical Campus, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Aurora, Colorado, and Denver Veterans Affairs Medical Center, Denver, Colorado 80045, USA. cecilia.wang@ucdenver.edu
Cecilia C Low
CC
Wang
Jane E B
JE
Reusch
D000419:Albuminuria / Q000517:prevention & control; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D048909:Diabetes Complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents