Diabetes and atherosclerosis: mechanisms and management

To discuss the association of diabetes and atherosclerosis and outline various management options.

We reviewed the findings in pertinent studies in the literature.

Atherosclerosis accounts for virtually 80% of all diabetes-related mortality. It is also a principal reason for hospitalization of patients with diabetes. Diabetes profoundly affects the pathogenesis of atherosclerosis through various mechanisms. Established cardiovascular risk factors are more prevalent in diabetic than in nondiabetic patients. Although trials of intensive glycemic control have been somewhat disappointing for decreasing atherogenesis, the results of trials with lipid-regulating therapies have been more encouraging.

Atherogenesis is a multifactorial, multi-stepped process. Although established risk factors do not entirely explain the increased risk of cardiovascular disease in patients with diabetes, they do seem to have a major role. Therefore, the management of patients with diabetes must address these contributing risk factors.