Treatment Goals: The “A, B, Cs” of Diabetes Treatment

Given the clustering of heart disease risk factors, most people with type-2 diabetes require careful management of their blood glucose (as measured by the Hemoglobin A1c test), blood pressure and blood lipids.

 

The Chronic Effects of Hyperglycemia

There are several effects of prolonged hyperglycemia. In people with diabetes, damage to large blood vessels (macrovascular disease) can occur, increasing the risk of heart attack, stroke, and poor circulation in the hands and feet.

Diabetes is considered to be a leading risk factor for cardiovascular disease, along with smoking, high blood pressure, elevated cholesterol, and obesity. Although cardiovascular disease is the leading cause of death for people with diabetes, the majority (more than two thirds) are unaware of their increased risk for heart disease.

Diabetes accelerates the development of atherosclerosis, which narrows the arteries and increases the risk of a heart attack or stroke. Hyperglycemia, dyslipidemia, and hypertension all may contribute to the development of atherosclerosis and cardiovascular disease in people with diabetes. Recent evidence suggests that inflammation also plays an important role here.

Cardiovascular disease is the leading cause of death in people with diabetes. Coronary artery disease and stroke account for approximately 65% of all deaths in people with diabetes. Peripheral vascular disease (poor circulation in the extremities, such as hands and feet) is a major risk factor for lower extremity amputations.