[Conservative treatment of diabetic microangiopathy and macroangiopathy]

Vascular complications represent the most frequent and the most serious complication of diabetes type 1 and type 2. High attention is paid to all manifestations of microangiopathy and macroangiopathy not only in studies of their pathogenesis, but also in numerous clinical reports revealing significant effect of conservative treatment in vascular diseases. It concerns namely microalbuminuria and proteinuria and also to the manifestations of diabetic nephropathy which are largely affected by antihypertensive and fibrate treatment as well as to diabetic retinopathy treatable by fibrates. In the treatment of diabetic microangiopathy a consistent attention must be paid to the treatment of hypertension and dyslipidemia, preferably using combinations of hypolipidemics. Already during selection of antidiabetics, possible vascular effects should be considered. Vascular wall and manifestations of vascular diseases can be positively influenced by so called insulin sensitizers, derivatives of sulphonylurea and metformin. In preparation there exist some other substances for the treatment of diabetic complications. Already now, every medical doctor should be able to select adequate treatment with antihypertensives, hypolipidemics and antidiabetics for the prevention or therapy of vascular diabetic complications.