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Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Diseases

Background:

  • Diabetes mellitus is a prevalent chronic disease with high mortality rates.
  • Coronary artery disease accounts for a significant portion of deaths in diabetic individuals.
  • While glycaemic control aids microvascular issues, overly strict control may pose cardiovascular risks.

Purpose of the Study:

  • To re-evaluate the optimal glycaemic control strategy for diabetic patients.
  • To emphasize early intervention over solely focusing on 'lower is better' glucose levels.
  • To advocate for a comprehensive management plan for cardiovascular risk in diabetes.

Main Methods:

  • Review of existing studies on glycaemic control and cardiovascular outcomes in diabetes.
  • Analysis of the impact of tight versus less strict glycaemic control.
  • Assessment of multidisciplinary treatment strategies for cardiovascular risk factors.

Main Results:

  • Improving glycaemic control is beneficial for microvascular complications.
  • Excessively tight glycaemic control can be detrimental, particularly in high-cardiovascular-risk patients.
  • A shift from 'lower the better' to 'earliest the best' glycaemic management is suggested.

Conclusions:

  • Optimal diabetes management necessitates a nuanced approach to glycaemic control.
  • A multidisciplinary strategy integrating hypoglycaemic agents, antihypertensives, and statins is crucial.
  • Early and comprehensive management of cardiovascular risk factors is vital for diabetic patients.