[Prevention of macroangiopathy of type 2 diabetes in clinical practice]

The increase in cardio-vascular morbidity of people with Type 2 diabetes is due to the frequent association of Type 2 diabetes with classical risk factors but also to diabetes per se, whatever the mechanisms involved. From a clinical point of view, it is important to stop smoking, with a great benefit, to treat hypertension with other drugs than diuretics or beta-blockers and to treat dyslipidaemia. The lipid abnormalities often improve with the only glycaemic control. In all cases, the normalisation of HbA1c is a very important therapeutic goal, by diet, exercise, oral hypoglycaemic drugs or insulin if necessary. The treatment will be especially useful in high risk patients, i.e. patients with coronary heart disease, patients with albuminuria, patients with more than 3 risk factors associated with diabetes and/or with high glycaemic levels.