[Prevention of cardiovascular risk in diabetes]

Abstract

Cardiovascular risk is related to increasing levels of blood glucose, even below those defining diabetes. However, this is a statistical association, but causality was not demonstrated by clinical trials. It is recommendable to adjust HbA1c <7 %, because this objective was proved to protect against microvascular disease. If microcirculation is intact, then post-CV event prognosis is similar to that seen in people without diabetes. Non-glycaemic strategies must be agressive in people with type 2 diabetes regarding classical risk factors: blood pressure, lipids, anti-platelet agents. A multiple intervention strategy was shown to be effective in type 2 diabetic subjects with microalbuminuria. Clinical trials aimed at normalizing blood glucose to reduce CV events will be available within 5 years.