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Complex management in diabetic patients with cardiovascular disease


Authors: Ján Murín 1;  Martin Wawruch 2;  Soňa Kiňová 1
Authors‘ workplace: I. interná klinika LFUK a UNB, Nemocnica Staré Mesto, Bratislava 1;  Ústav farmakológie a klinickej farmakológie LF UK a UNB, Nemocnica Staré Mesto, Bratislava 2
Published in: Forum Diab 2018; 7(1): 10-17
Category:

Overview

Diabetes mellitus type 2 (DM2T) has an epidemic prevalence in our societies and a life-risk for development of diabetes in Europe is about 30–40 %. When a dia­betes is recognized in a patient, he or she is usually seriously cardiovascularly ill. We therefore search always for the presence of diabetes in every patient with a cardiovascular disease. Diabetes accelerates development of atherosclerosis and therefore enormously increases also cardiovascular morbidity and mortality. A diabetic patient with another cardiovascular risk factor or with a target organ damage has a very high cardiovascular risk and he is in need of intensive treatment of all risk factors or cardiovascular diseases. We try to manage all his cardiovascular risk factors: hypertension (combined antihypertensive treatment – RAAS blockers included, with treated blood pressure ≤ 140/90 mm Hg), atherogenic dyslipidemia (atorva- or rosuvastatin in a high dose), antiplatelet treatment (aspirin, sometimes twice a day, or clopidogrel), antidiabetic drugs which reduce cardiovascular events (SGLT2 inhibitor or liraglutid) – STENO-2 study showed that with a control of all risk factors mortality can be reduced by 50%. Diabetic patient is in need of consultation with a diabetologist, but also cardiologist, nephrologist or some other experts.

Key words:
cardiovascular disease, diabetes mellitus type 2, risk factors

Received:
28. 11. 2017

Accepted:
5. 1. 2018


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