[Diabetes and heart]

Diabetics are subjects to a high cardiovascular risk. This concept is now accepted by all and has been demonstrated in clinical practice by the constantly increasing number of diabetic cardiac patients and cardiac diabetics. The many therapeutic trials carried out on the prevention of cardiovascular complications in diabetics have made it possible to define therapeutic goals. HbA1c must be less than 6.5%. Target blood pressure values are 130/80 mmHg or even 125/75 in the case of renal insufficiency. If conventional treatments have proven efficacy against stroke and coronary events, only molecules which modulate the renin-angiotensin-aldosterone system provide additional nephroprotection in diabetics. However, single-agent therapy is seldom sufficient to achieve glycaemic or blood pressure targets. Diabetic dyslipidemia also requires attentive management, usually by a statin, with a target LDL cholesterol < 1 g/l at the onset of microalbuminuria. All these measures should make it possible to obtain a significant reduction in the cardiovascular risk of diabetic patients.