Macrovascular effects and safety issues of therapies for type 2 diabetes

Am J Cardiol. 2011 Aug 2;108(3 Suppl):25B-32B. doi: 10.1016/j.amjcard.2011.03.014.

Abstract

Type 2 diabetes has long been recognized as an independent risk factor for cardiovascular disease (CVD), including coronary artery disease (CAD), stroke, peripheral arterial disease, cardiomyopathy, and congestive heart failure. Cardiovascular (CV) complications are the leading cause of comorbidity and death in the patient with diabetes. Vascular complications of diabetes also extend to microvascular disease, manifest as diabetic nephropathy, neuropathy, and retinopathy. The impact of glycemic control in reducing microvascular complications is well established. Although more controversial, there is also evidence that glycemic control can limit macrovascular disease, including CAD, peripheral arterial disease, and stroke. Glycemic control in the context of type 2 diabetes, as well as prediabetes, is also intertwined with CV risk factors such as obesity, hypertriglyceridemia, and blood pressure control. Similarly, major issues and concerns have arisen around the CV safety of antidiabetic therapy. Together, these issues have focused attention on the need to understand the CV effects of current treatments for type 2 diabetes and the optimal strategies for care of patients with this disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atherosclerosis / epidemiology
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Angiopathies / chemically induced
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Retinopathy / physiopathology
  • Disease Progression
  • Glycated Hemoglobin
  • Humans
  • Hyperglycemia / epidemiology
  • Hypertriglyceridemia / epidemiology
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Obesity / epidemiology
  • Pioglitazone
  • Risk Factors
  • Thiazolidinediones / therapeutic use

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Thiazolidinediones
  • Pioglitazone