Criteria for metabolic control and intervention in diabetes

Guidelines for optimal management of diabetes advocate comprehensive strategies to treat all established risk factors for coronary heart disease (CHD). The targets for treatment should be optimization of glycemic control, weight reduction, lowering of elevated blood pressure, correction of lipid abnormalities, and stopping smoking. Recently, strong evidence has emerged to demonstrate that poor glycemic control is a powerful predictor for excess CHD risk. The fact that dyslipidemia and hypertension are frequent in NIDDM patients at the time of diagnosis indicates that these risk factors may cause damage for years before the actual diagnosis of NIDDM. This article highlights the current background knowledge for the guidelines of therapeutic strategies for dyslipidemias in NIDDM.