Pharmacotherapy of diabetes mellitus type 2. From the glucocentric tradition towards cardiovascular risk management

Der Internist
S Jacob, N Marx

Abstract

Patients with diabetes type 2 are not directly endangered by dysglycemia but they suffer vascular complications. The diabetic patient with existing cardiovascular disease has a particularly high risk for further cardiovascular complications and therefore requires specific attention. This is not only due to the hyperglycemia, but due to the coexistence of further cardiovascular risk factors, such as hypertension, dyslidemia, visceral fat accumulation, chronic inflammation and coagulopathy, also clinically described as the metabolic syndrome. These patients need an intense and multi-modal therapeutic approach, not only for improvement of glycemic control. Also other vascular risk factors should be handled aggressively, such as blood pressure, coagulopathy and dyslipidemia. Recent studies--as STENO 2--indicate that a multi-modal and aggressive approach in diabetic patients can markedly improve their prognosis. Therefore, the current practice of a glucocentric approach should be changed towards a more vascular approach.

References

Jan 31, 2003·The New England Journal of Medicine·Peter GaedeOluf Pedersen
Jun 18, 2003·Journal of Diabetes and Its Complications·Antonella CaselliAristidis Veves
May 14, 2005·Circulation Research·Anders H Berg, Philipp E Scherer
Nov 24, 2005·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Daniel Walcher, Nikolaus Marx

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