[Guidelines for the management of atherosclerotic diseases in diabetes mellitus]

Abstract

Diabetes mellitus is associated with a greater risk of developing atherosclerosis and its complications: myocardial infarction, stroke and peripheral vascular disease. In patients with diabetes, atherosclerosis represents a complex multifactorial disease with increased lesion progression and severity compared to the nondiabetic population. Several risk factors have been proposed to explain the increased risk of cardiovascular disease with diabetes. They include: hyperglycemia, hypertension, dyslipidemia, obesity and other factors. It is difficult to precisely establish the elements leading to diabetes-accelerated atherosclerosis by means of epidemiological studies because all these factors coexist in diabetic patients. Then, management of atherosclerosis in diabetes is a multifactorial process involving nonpharmacological interventions like exercise, diet control, and pharmacological therapy directed at hypertension, hyperglycemia, and dyslipidemia.