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Understanding cardiovascular outcomes in type 2 diabetes

Academic Unit of Cardiovascular Medicine, The LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, LS2 9JT, West Yorkshire, UK, s.b.wheatcroft{at}leeds.ac.uk

Mark T Kearney

Although morbidity and mortality from cardiovascular disease are decreasing overall, individuals with type 2 diabetes remain at significantly increased risk. Diabetes-related coronary artery disease currently accounts for a substantial proportion of a cardiologist's workload, and this is likely to increase further with the increasing prevalence of obesity. Patients with type 2 diabetes or metabolic syndrome typically have visceral obesity, which, along with insulin resistance, is becoming an increasingly important risk factor for cardiovascular disease. Visceral adipose tissue is now established as a metabolically active organ, which is thought to contribute to vascular disease by secreting a range of cytokines and other pro-inflammatory mediators. Furthermore, evidence is accumulating that the long period of insulin resistance, which typically precedes the onset of diabetes , may be an important factor underlying the development of atherosclerosis. The continuing tendency toward adverse cardiovascular outcomes in those with type 2 diabetes, despite optimal management of conventional risk factors, argues for intensified efforts to prevent or delay the development of atherosclerotic disease. With the prevalence of obesity and type 2 diabetes continuing to increase, it is essential to focus treatment strategies on the pre-diabetes phase in order to significantly impact on cardiovascular event rates in the future.

Key Words: metabolic syndrome • visceral obesity • insulin resistance • pro-inflammatory state • accelerated atherosclerosis • cardiovascular events.

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The British Journal of Diabetes & Vascular Disease, Vol. 6, No. 2 suppl, S7-S11 (2006)
DOI: 10.1177/14746514060060020301


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Wheatcroft, S. B Articles by Kearney, M. T Search for Related Content Social Bookmarking                         What's this?