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The British Journal of Diabetes & Vascular Disease
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Cardiovascular events in patients with type 2 diabetes

Erland Erdmann

Clinic for Internal Medicine, University of Köln, Joseph Stelzmann Str. 9, Köln D-50924, Germany, erland.erdmann{at}uni-koeln.de

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

Key Words: coronary heart disease • pioglitazone • risk factors • type 2 diabetes.

The British Journal of Diabetes & Vascular Disease, Vol. 2, No. 1 suppl, S4-S8 (2002)
DOI: 10.1177/14746514020020010201
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