Abstract
Diabetes is strongly linked with macrovascular complication (ischemic heart disease, stroke, peripheral arterial disease). Several mechanisms boost arteriosclerosis: hyperglycemia, impaired lipid metabolism, insulin resistance, oxidative stress, release of proinflammatory cytokines, coagulopathies and fibrinolysis disorders, and endothelial dysfunction. Cardiovascular diseases are commonest in diabetic patients, being the mainly cause of morbi- and mortality among them, evolving worse than non-diabetic patients, independently of treatment stablished. Treatment has to be supported on: life-style, loss weight (decreased calorie intake and increased physical activity), and pharmacological therapy. Once diagnosis is performed, metformin has to be initial treatment; then sodium glucose cotransporter 2 inhibitors or glucagon-like peptide 1 agonists are recommended for diabetic patients with atherosclerotic cardiovascular disease or high-risk factor for it.
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