Abstract
Reducing cardiovascular risk (CVR) is the main focus of diabetes mellitus (DM) management nowadays. Complex pathogenic mechanisms that are the subject of this review lead to early and severe atherosclerosis in DM patients. Although it is not a cardiovascular disease equivalent at the moment of diagnosis, DM subjects are affected by numerous cardiovascular complications, such as acute coronary syndrome, stroke, or peripheral artery disease, as the disease duration increases. Therefore, early therapeutic intervention is mandatory and recent guidelines focus on intensive CVR factor management: hyperglycaemia, hypertension, and dyslipidaemia. Most important, the appearance of oral or injectable antidiabetic medication such as SGLT-2 inhibitors or GLP-1 agonists has proven that an antidiabetic drug not only reduces glycaemia, but also reduces CVR by complex mechanisms. A profound understanding of intimate mechanisms that generate atherosclerosis in DM and ways to inhibit or delay them are of the utmost importance in a society where cardiovascular morbidity and mortality are predominant.
Highlights
Cardiovascular complications account for more than 70% of all hospital admissions in diabetic patients in the USA [1]
The latest research shows that a high triglyceride/HDL-cholesterol ratio is correlated with insulin resistance in type 2 diabetes mellitus (DM) and represents a cardio-vascular risk predictor [6]
SGLT-2 inhibitors) is GLP-1 an important therapies that act on inhibiting generated factors
Summary
Cardiovascular complications account for more than 70% of all hospital admissions in diabetic patients in the USA [1]. Patients with peripheral artery disease present a high risk of developing lower limb ulcerations and 15 times greater risk of amputation in contrast with non-diabetic patients [7] as a result of infection with multiple pathogens [8]. The authors’ objectives were as follows: to identify comorbidities of DM patients that share the same pathogenic substrate with DM (insulin resistance and factors that further increased the atherosclerotic risk); to highlight the most common CVR factors in DM and the importance of identifying them early in a patient with diabetes, as well as their management according to the new guidelines All these objectives were achieved by analysing the information provided by some of the most recent works published in the specialized literature
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