Type 2 diabetes mellitus: prevention of macrovascular complications

Abstract

Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary heart disease, stroke or peripheral artery disease. Optimal control of elevated blood glucose levels will reduce the symptoms of hyperglycemia and help to prevent the development of complications. In addition, treatment of hypertension and lipid disturbances has been shown to reduce the incidence and severity of vascular complications significantly. The current treatment goals focus on adequate and aggressive treatment of these three risk factors. The central dogma for treatment of blood glucose, blood pressure and cholesterol levels is ‘the lower the better’. Ongoing trials evaluate the effect of further lowering these treatment goals and of specific types of medication on cardiovascular events.

Keywords::

• aspirin
• dyslipidemia
• hyperglycemia
• hypertension
• Type 2 diabetes
• vascular complications

Financial & competing interests disclosure

BHR Wolffenbuttel has served on the advisory panel for Eli Lilly, GSK, Novo Nordisk and Pfizer. He has also been a consultant for Eli Lilly and provided research support to AMGEN, Astra Zeneca, Becton Dickinson, Eli Lilly, Johnson & Johnson, Novartis, Novo Nordisk and Pfizer. 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.

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