Cardiovascular disease is the most important cause of mortality and morbidity among patients with type 2 diabetes; however, the reasons for this excess risk are only partially known. Conventional risk factors (high total and low density lipoprotein cholesterol, elevated blood pressure, and smoking) contribute in to cardiovascular disease in patients with type 2 diabetes similarly to the way they do in nondiabetic subjects. In nondiabetic subjects, a slight elevation of glucose in the nondiabetic range of glycemia is already associated with an increased risk for cardiovascular disease. Similarly, recent prospective studies have convincingly indicated that hyperglycemia contributes to total mortality and cardiovascular complications in patients with type 2 diabetes, although the effect of poor glycemic control to increase the risk of cardiovascular disease seems to be lower than that of conventional risk factors. Accordingly, the United Kingdom Prospective Diabetes Study showed that intensive glucose control effectively reduced microvascular complications among patients with type 2 diabetes, but its effect on the prevention of cardiovascular complications was limited.
Department of Medicine, University of Kuopio, Kuopio, Finland.
Correspondence to Markku Laakso, MD, Professor and Chair, Department of Medicine, University of Kuopio, 70210 Kuopio, Finland; e-mail: email@example.com