[Diabetes mellitus and atherosclerosis. Physiopathology of diabetic macroangiopathy].

Numerous prospective epidemiological studies point out high mortality prevalence in diabetic subjects. Classical risk factors, especially arterial hypertension and hypertriglyceridaemia, are abnormally associated with diabetes mellitus. However, they don't account for overall surmortality in this disease. Additional markers of cardiovascular risk appeared as albuminuria, abdominal obesity, and the couple insulinoresistance/hyperinsulinism. Physiopathological intrinsic mechanisms inherent to macroangiopathy are multiple and intricate (hemostatic disorders, endothelial impairments, oxidative stress, quantitative and qualitative lipoproteins abnormalities, part of hyperinsulinism and growth factors). Strict normoglycaemia and exacting control of all other risk factors is essential. Use of other therapeutic agents as antioxidants and antiagregants, is discussed.