Cardiovascular Risk Factor Control in Type 2 Diabetes Mellitus and New Trial Evidence

*Peter M. Nilsson

Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
*Correspondence to Peter.Nilsson@med.lu.se

Disclosure: The author has declared no conflicts of interest.
Acknowledgements: The review was supported by a grant from the Research Council and the Heart and Lung Foundation of Sweden.
Received: 19.09.16 Accepted: 28.11.16
Citation: EMJ. 2017;2[1]:83-89.

Abstract

The micro and macrovascular complications of Type 2 diabetes mellitus are influenced by several well described cardiovascular risk factors such as hyperglycaemia, hypertension, hyperlipidaemia, and smoking alongside age, sex, and diabetes duration. Modern guidelines have defined treatment and goals for these risk factors based on evidence. As new trials are constantly published, these risk factors must be analysed for evidence to contribute to guidelines that are being revised. During recent years three new trials (EMPA-REG, LEADER, and SUSTAIN-6) have shown that treatment of hyperglycaemia with new anti-diabetic drugs has been able to reduce a composite cardiovascular endpoint. This is a great achievement and is the focus of this review, which also summarises developments in the treatment of other relevant risk factors. Ultimately, a high-quality level of diabetes care also needs to involve a well-informed and motivated patient; if compliance is suboptimal the benefits of modern treatment will not be reached.

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