[Multifactorial approach of the cardiovascular risks in case of diabetes]

All patients with type 2 diabetes are at increased risk of cardiovascular diseases. Diabetics have a greater burden of atherogenic risk factors than non diabetics including mainly arterial hypertension and dyslipidemia. If strict glycemic control is recommended because of proved benefit in terms of microvascular disease the protection against macrovascular disease is less established. Vigorous risk factors reduction (diminution of blood pressure, reduction of lipids, smoking cessation) should be a priority in a multifactorial approach of diabetes treatment, involving the patients and the doctors. In addition to lifestyle and behaviour counselling, polypharmacologic treatment is often needed.