Cardiology patient pages. Cardiovascular disease in the diabetic patient.

Abstract

Diabetes mellitus is a chronic metabolic disease characterized by a high blood sugar level. Over 17 million Americans are affected by the disease. About 10% of the US population over the age of 60 years has diabetes, with a disproportionately high number of black, Hispanic, Asian, and Native Americans affected. Furthermore, it is estimated that fully half of the population with diabetes remains undiagnosed. Diabetes may be caused by decreased insulin secretion, decreased insulin action, or both. Insulin, a hormone made in the pancreatic B-cell, assists in the transportation into cells and the use of sugar by cells throughout the body. Whether the body cannot make sufficient insulin or the insulin that is made does not function well in the body, the blood sugar level becomes elevated. Over time, increased blood sugars can damage both small and large blood vessels. In patients with type 1 diabetes, for unknown reasons, there is an autoimmune destruction of the insulin-secreting pancreatic B-cells, and insulin injections must be taken to survive. This type of diabetes represents less than 10% of all diabetes cases. In contrast, type 2 diabetes occurs in more than 90% of all patients with diabetes and is characterized by both insulin resistance and a relative reduction in insulin production. In type 2 diabetes, the treatment goal is to match the amount of insulin that the body can make to the amount that the body needs. There are many possible treatment options that the physician may initially prescribe; however, all regimens are based on healthy food choices and daily activity. If these lifestyle changes do not work, …