[Implications of the REACH registry for endocrinologists]

Diabetes mellitus is a major public health problem due to its increasing incidence in the general population and the morbidity and mortality associated with micro- and macrovascular complications. Patients with diabetes have a 2-5-fold increased risk of coronary heart disease, stroke and peripheral artery disease. The REACH registry is the largest observational study in the world designed to assess prognostic and therapeutic data in the population with elevated risk for atherothrombotic events. The results of this study show a high prevalence of obesity, diabetes mellitus and metabolic syndrome in the population with increased cardiovascular risk. Moreover, the data demonstrate that metabolic control of diabetes mellitus is clearly inadequate. Data from the REACH registry show endocrinologists and diabetologists that a multidisciplinary approach is imperative and that adequate management of diabetic patients should include stratification of cardiovascular risk, including assessment of associated conditions such as obesity, hypertension, dyslipidemia, microalbuminuria and smoking.