Abstract
Epidemiologic studies show a worldwide diabetic epidemic. Diabetes mellitus is associated with a reduced life span due to macro vascular and micro vascular complications. Thus, diabetic nephropathy, which is the major cause of morbidity and mortality for patients with either type 1 diabetes mellitus or type 2 diabetes mellitus, is a public health care problem. Blood pressure control is a proven intervention to prevent progression of diabetic nephropathy and to reduce cardiovascular events in patients with diabetes mellitus. Establishment of optimal blood pressure targets, advantages of one class of drugs over another as well as time of initiation of antihypertensive therapy are those important questions that appear before every doctor. This review addresses these issues.
Highlights
Diabetes mellitus is becoming pandemic in the US and all over the world
More than 90% of diabetes in the United States represented is Type 2 Diabetes Mellitus (T2DM) which is associated with a 70–80% chance of premature death from cardiovascular disease
Diabetes mellitus is associated with macrovascular disease; affecting the heart; brain and lower extremities; and Microvascular pathology; which leads to blindness; diabetic neuropathy and diabetic nephropathy
Summary
Diabetes mellitus is becoming pandemic in the US and all over the world. In 2011 the prevalence of diabetes was 366 million people and is predicted to rise to 552 million by 2030 worldwide [1]. VADT study (Veterans Affairs Diabetes Trial) of patients with T2DM again did not show significant effect of tight glucose control on the rates of major cardiovascular events; death or microvascular complications; with the exception of progression of albuminuria [36].
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