The importance of treating multiple cardiometabolic risk factors in patients with Type 2 diabetes

Figures & data

Figure 1. Established and emerging cardiometabolic risk factors.

Figure 2. Adipokines linked to inflammation. Modified with permission, from TRAYHURN P, WOOD IS: Biochem. Soc. Transact. (2005) 33:1078-1081. Copyright the Biochemical Society.

Table 1. International Diabetes Federation definition of the metabolic syndrome: ethnic-specific values for waist circumference.

Ethnic group	Waist circumference (cm)
Europids
Men	≥ 94
Women	≥ 80
South Asians
Men	≥ 90
Women	≥ 80
Chinese
Men	≥ 90
Women	≥ 80
Japanese
Men	≥ 85
Women	≥ 90
Ethnic South and Central Americans	Use South Asian recommendations until more specific data are available
Sub-Saharan Africans	Use European recommendations until more specific data are available
Eastern Mediterranean and Middle East (Arab) populations	Use European recommendations until more specific data are available
Ethnicity and not country of residence should be the basis for classification

Data are pragmatic cutoffs and better data are required to link them to risk.

Table 2. The effect of rimonabant on established and emerging cardiometabolic risk factors in patients with Type 2 diabetes.

Change from baseline	Rimonabant (20 mg/day)	Placebo	p-Value
Weight	-5.3 kg	-1.4 kg	< 0.0001
Waist circumference	-5.2 cm	-1.9 cm	< 0.0001
HbA1c (%)	-0.6	0.1	< 0.0001
Patients achieving HbA1c < 7.0%	68%	48%	< 0.0001
HDL-C	15.4%	7.1%	< 0.0001
Non-HDL-C	-1.8%	2.5%	0.01
Triglycerides	-9.1%	7.3%	< 0.0001
Systolic blood pressure	-0.8 mmHg	1.6 mmHg	0.02
hsCRP	-1.4 mg/l	0.0 mg/l	0.02
Leptin	-0.3 ng/ml	3.1 ng/ml	< 0.0001

Data from the Rimonabant in Obesity-Diabetes trial [87].

HbA_1c: Glycated haemoglobin; HDL-C: High-density lipoprotein cholesterol; hsCRP: High-sensitivity C-reactive protein.

SCHEEN AJ, FINER N, HOLLANDER P, JENSEN MD, VAN GAAL LF: Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study. Lancet (2006) 368(9548):1660-1672.

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