Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Am J Cardiol. 2011 Aug 2;108(3 Suppl):25B-32B. doi: 10.1016/j.amjcard.2011.03.014.
Type 2 diabetes has long been recognized as an independent risk factor for cardiovascular disease (CVD), including coronary artery disease (CAD), stroke, peripheral arterial disease, cardiomyopathy, and congestive heart failure. Cardiovascular (CV) complications are the leading cause of comorbidity and death in the patient with diabetes. Vascular complications of diabetes also extend to microvascular disease, manifest as diabetic nephropathy, neuropathy, and retinopathy. The impact of glycemic control in reducing microvascular complications is well established. Although more controversial, there is also evidence that glycemic control can limit macrovascular disease, including CAD, peripheral arterial disease, and stroke. Glycemic control in the context of type 2 diabetes, as well as prediabetes, is also intertwined with CV risk factors such as obesity, hypertriglyceridemia, and blood pressure control. Similarly, major issues and concerns have arisen around the CV safety of antidiabetic therapy. Together, these issues have focused attention on the need to understand the CV effects of current treatments for type 2 diabetes and the optimal strategies for care of patients with this disease.
2 型糖尿病长期以来一直被认为是心血管疾病(CVD)的独立危险因素,包括冠状动脉疾病(CAD)、中风、外周动脉疾病、心肌病和充血性心力衰竭。心血管(CV)并发症是糖尿病患者合并症和死亡的主要原因。糖尿病的血管并发症也扩展到微血管疾病,表现为糖尿病肾病、神经病变和视网膜病变。血糖控制对降低微血管并发症的影响已得到充分证实。尽管存在更多争议,但也有证据表明血糖控制可以限制大血管疾病,包括 CAD、外周动脉疾病和中风。2 型糖尿病以及糖尿病前期的血糖控制也与肥胖、高三酰甘油血症和血压控制等心血管危险因素交织在一起。同样,围绕抗糖尿病治疗的心血管安全性也出现了重大问题和担忧。综上所述,这些问题都促使人们关注了解当前 2 型糖尿病治疗方法的心血管效应以及此类患者的最佳护理策略的必要性。