Diabetes and vascular disease

Abstract

Type 2 diabetes has reached epidemic proportions and is now recognized as a coronary heart disease equivalent. While the most common metabolic abnormality associated with diabetes is hyperglycemia, there are also abnormalities in carbohydrate, fat and protein metabolism. These abnormalities increase oxidative stress and activate the renin–angiotensin system leading to endothelial dysfunction and, thereafter, to systemic atherosclerosis. This systemic atherosclerosis is responsible for the increased cardiovascular morbidity and mortality related to diabetes. In this article, we review the evidence and discuss the rationale for comprehensive risk reduction to prevent and treat vascular disease in individuals with diabetes mellitus. The components of comprehensive risk reduction strategy consist of lifestyle changes, glycemic control, control of dyslipidemia and hypertension.

Keywords::

• cardiovascular disease
• cerebrovascular disease
• coronary artery disease
• diabetes mellitus
• peripheral arterial disease

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.