Type-2 diabetes mellitus and cardiovascular disease

The global prevalence of diabetes has risen in adults from 4.7% in 1980 to 8.5% in 2014. 90-95% of adults with diabetes have Type 2 diabetes (T2D). This paper focuses on the diagnosis and treatment of T2D patients who have or are at risk for cardiovascular disease. Hyperglycemia, insulin resistance...

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Bibliographic Details
Published in:Future cardiology 2018-11, Vol.14 (6), p.491-509
Main Author: Henning, Robert J
Format: Article
Language:English
Subjects:
adult onset diabetes
Adults
Cardiovascular disease
coronary artery disease
Coronary vessels
Diabetes
Glucose
glucose lowering agents
HbA1c
Health risk assessment
Heart attacks
Heart failure
Heart surgery
Hemoglobin
Hyperglycemia
Hypertension
Insulin resistance
Ischemia
macrovascular disease
Medical diagnosis
microvascular disease
Mortality
myocardial infarction
obesity
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Summary:The global prevalence of diabetes has risen in adults from 4.7% in 1980 to 8.5% in 2014. 90-95% of adults with diabetes have Type 2 diabetes (T2D). This paper focuses on the diagnosis and treatment of T2D patients who have or are at risk for cardiovascular disease. Hyperglycemia, insulin resistance and excess fatty acids increase oxidative stress, disrupt protein kinase C signaling and increase advanced glycation end-products that result in vascular inflammation, vasoconstriction, thrombosis and atherogenesis. Intensive T2D treatment produces a ≥10% risk reduction in major macrovascular and microvascular events. Glucose-lowering therapies must be individualized. Metformin is an optimal drug for monotherapy. If hemoglobin A1c is not at goal, a sodium-glucose cotransporter-2 inhibitor or a dipeptidyl peptidase-4 inhibitor should be considered for therapy with metformin. Coronary angioplasty/stenting is recommended for diabetic patients with acute myocardial infarctions. Coronary artery bypass grafting is recommended for symptomatic diabetic patients with multivessel disease.
ISSN:1479-6678
1744-8298
DOI:10.2217/fca-2018-0045