J Korean Diabetes.  2011 Dec;12(4):198-200. 10.4093/jkd.2011.12.4.198.

Treatment Strategy for Diabetes with Cardiovascular Disease

• Jang YM
• Kim SK

• KMID: 2059851
• DOI: http://doi.org/10.4093/jkd.2011.12.4.198

Abstract

Individuals with diabetes mellitus are at 2- to 3-fold increased risk of cardiovascular disease relative to individuals without diabetes, and hypoglycemia is associated with increased cardiovascular mortality in diabetic patients. Here, we present a discussion of multiple hypoglycemic drugs and their cardiovascular effects. In addition, we provide summary recommendations for glucose-lowering regimens in patients with diabetes and cardiovascular diseases.

Keyword

Diabetes mellitus; Cardiovascular diseases

MeSH Terms

Cardiovascular Diseases
Diabetes Mellitus
Humans
Hypoglycemia
Hypoglycemic Agents
Hypoglycemic Agents

Figure

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  Fig. 1. Proposed antihyperglycemic starategy in the patient with type 2 diabetes mellitus and cardiovascular disease.

Reference

1. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998; 352:854–65.

2. Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, Skene AM, Tan MH, Lefèbvre PJ, Murray GD, Standl E, Wilcox RG, Wilhelmsen L, Betteridge J, Birkeland K, Golay A, Heine RJ, Korányi L, Laakso M, Mokán M, Norkus A, Pirags V, Podar T, Scheen A, Scherbaum W, Schernthaner G, Schmitz O, Skrha J, Smith U, Taton J. PROactive investigators. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomized controlled trial. Lancet. 2005; 366:1279–89.

3. Flynn DM, Smith AH, Treadway JL, Levy CB, Soeller WC, Boettner WA, Wisniecki P, Plowchalk DR, Gernhardt SS, Tracey WR, Knight DR. The sulfonylurea glipizide does not inhibit ischemic preconditioning in anesthetized rabbits. Cardiovasc Drugs Ther. 2005; 19:337–46.

4. Mocanu MM, Maddock HL, Baxter GF, Lawrence CL, Standen NB, Yellon DM. Glimepiride, a novel sulfonylurea, does not abolish myocardial protection afforded by either ischemic preconditioning or diazoxide. Circulation. 2001; 103:3111–6.

5. Balkau B, Eschwège E. Epidemiological data on postprandial glycaemia. Diabetes Metab. 2006; 32(Spec No2):2S5–9.

6. Davidson MH. Cardiovascular effects of glucagonlike peptide-1 agonists. Am J Cardiol. 2011; 108(3 Suppl):33B–41B.

7. Malmberg K. Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus. DIGAMI (Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group. BMJ. 1997; 314:1512–5.

8. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352:837–53.

9. American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care. 2010; 33(Suppl 1):S11–61.