title: Glucose and LDL lowering: the need for intensive therapy.
abstract: In almost every epidemiological analysis so far performed a strong correlation always emerges between degree of hyperglycemia and risk of both micro- and macrovascular complications. However, whereas lowering plasma glucose levels by intensive treatment has proven to reduce the risk of development of retinopathy, nephropathy and neuropathy, the effect on macrovascular complications has remained quite doubtful. Multiple factors may have concurred to this negative findings including long duration of diabetes, poor pre-existing glycaemic control, potentially inadequate anti-diabetes drugs. Another potential explanation is that, given the high cardiovascular risk of the diabetic patients they were already aggressively treated as far as their cardiovascular risk factors are concerned. The annual mortality in these diabetic cohorts was, indeed, incredibly close to that of the non-diabetic population. These considerations along with the results of multiintervention studies, such as the Steno-2, supports the need for multifactorial intensive needs, definitely including glucose and lipid lowering.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Italy. stefano.delprato@med.unipi.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D015536:Down-Regulation; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008078:Cholesterol, LDL; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents