Cardiovascular disease prevention strategies for type 2 diabetes mellitus

ABSTRACT

Introduction: Type 2 diabetes mellitus (T2DM) is associated with several cardiovascular (CV) risk factors such as insulin resistance, obesity, hypertension, dyslipidaemia, non-alcoholic fatty liver disease as well as platelet and haemostatic abnormalities increasing the risk of thrombosis. Therefore, T2DM patients are at an increased risk for CV disease (CVD).

Areas covered: This narrative review discusses the treatment of T2DM. This includes lifestyle measures (diet, exercise and smoking cessation) as well as hypolipidaemic, antihypertensive, weight reducing, antiplatelet and glucose lowering drugs. The focus is on the effects of these therapeutic strategies on CVD risk. Randomized controlled clinical trials (RCTs) reporting CVD outcomes with such drugs in T2DM patients are also reviewed.

Expert opinion: Apart from current guidelines, the findings of RCTs on CVD outcomes in T2DM patients should be taken into consideration in daily clinical practice. Multiple risk factors should be targeted simultaneously in such high-risk patients in order to efficiently reduce the risk of CV events.

KEYWORDS:

• Type 2 diabetes mellitus
• cardiovascular risk
• antihypertensive
• hypolipidaemic drugs
• antidiabetic drugs
• antiplatelet drugs

Article highlights

1. Cardiovascular Disease Prevention in Type 2 Diabetes Mellitus.

LDL-C: low density lipoprotein cholesterol; PCSK9: proprotein convertase subtilisin/kexin 9 inhibitors.

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Declaration of interest

N Katsiki has given talks, attended conferences and participated in trials sponsored by Amgen, Angelini, Astra Zeneca, Boehringer Ingelheim, Galenica, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi and Win Medica. F Purrello has given talks or participated to advisory board sponsored by Novo Nordisk, Lilly, Sanofi, Boehringer Ingelheim, Astra Zeneca and Merck Sharp & Dohme. DP Mikhailidis has given talks and attended conferences sponsored by Merck Sharp & Dohme, AstraZeneca and Libytec. C Tsioufis declares research grant or honoraria from St. Jude Medical, Medtronic, AstraZeneca, Boehringer Ingelheim, Merck Sharp & Dohme, Novartis and Novo Nordisk. The authors have no other 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 apart from those disclosed.

Additional information

Funding

This paper was not funded.