Reducing the cardiovascular consequences of diabetes mellitus

Type 2 diabetes is an important, independent risk factor for cardiovascular disease. As a result of the pandemic explosion of Type 2 diabetes, reducing the human and financial consequences of the disease is a major healthcare concern. In primary prevention, antihypertensive treatment, aspirin and lipid-lowering intervention are effective at reducing the incidence of coronary heart disease although the beneficial effect of optimal glycaemic control remains to be conclusively proven. Type 2 diabetic patients with acute myocardial infarction should receive a specific programme of intensive treatment, which includes optimal glycaemic control using intensive insulin treatment, thrombolysis, and early use of beta-blockers and angiotensin-converting enzyme inhibitors. Secondary prevention is also essential because beta-blockers and lipid interventions are more effective in Type 2 diabetic patients than in non-diabetic patients with coronary artery disease. Unfortunately, too many Type 2 diabetic patients do not receive adequate treatment or do not comply with their long-term medical recommendations.