Glycemic control and cardiovascular protection

As we know diabetes is 5^th leading cause of death in united states. Every 1% rise in HbA1c is associated with a 30% increase in all cause mortality and a 40% increase in cardiovascular disease (CVD) mortality.

Overall mortality rate in T2DM is twice as high and CVD death rate is 2-4 times as high as those without diabetes.

Diabetes is a leading cause of blindness, renal failure and amputation in USA. These conditions can be slowed or prevented with optimal glycemic control.

Glucose is the driving force in microvascular complication of diabetes. In T2DM, insulin resistance and metabolic syndrome, the vasculature is exposed to frontal assault by hypertension, dyslipidemia (high TG – low HDL – high LDL), inflammation and impaired fibrinolysis. This toxic metabolic environment increases atherosclerotic risk in persons with metabolic syndrome, hyperglycemia and adds additional risk.

Strong epidemiological evidence suggests a correlation among glucose, atherosclerotic plaque burden, cardiovascular events and increase in morbidity and mortality.

Modification of traditional cardiovascular risk factors has an impressive impact on morbidity and mortality in diabetic in many studies.

Glucose control is only one of the factors to be considered so we should use intensified multifactorial intervention with:

Improved glycemia,
Control hypertension,
Treat dyslipidemia,
Weight reduction in obese or overweight person,
Cessation of smoking,
Lifestyle modification with regular exercise 20 -30 minutes a day and heathy foods

In this case the cardiovascular system would be protected.