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    Physicians have more options to provide CVD protection in diabetic patients

    A type 2 diabetes diagnosis carries with it a two- to threefold increased risk for cardiovascular disease (CVD), including myocardial infarction, stroke, peripheral vascular disease and death from cardiovascular disease. Patients with type 2 diabetes also typically present with several conventional risk factors for CVD including hypertension, lipid disturbances and inflammation.

    “That increased risk above individuals who do not have diabetes—men or women who are age-matched—relates, it’s thought, to glucose elevations, but recent clinical trials do not indicate that glucose lowering is the major feature by which protection ensued,” Robert H. Eckel, MD, professor of medicine in the division of endocrinology, metabolism and diabetes, and cardiology at the University of Colorado School of Medicine.

    Eckel said historically, trials in type 2 diabetes have compared aggressive treatment with insulin—where the dosage is optimized to lower blood sugar to as close to normal as possible—compared with a group treated close to the standard of care.

    “The outcomes of these trials have had pluses and minus,” Eckel said. “There is the suggestion that there might be a benefit for lowering glucose alone but it is not convincing enough to say that it is the only important risk factor for heart disease in patients with diabetes. “

    Next: New drug classes



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