Visoko tveganje za srčno-žilne bolezni pri sladkorni bolezni tipa 2: celostni pristop k zdravljenju = High cardiovascular risk in type 2 diabetes: multifactorial therapeutic approach
Medvešček, Marko
Cardiovascular disease is the main cause of premature death in type 2 diabetics. European guidelines for cardiovascular prevention from 2003 define diabetes as a high-risk category, and consequently ...recommend intensive risk factor management in this high-risk population. Cardiovascular prevention requires management of dyslipidemia and hypertension as primary targets, whilethe management of hyperglycemia decreases the risk of microangiopathic vascular damage. The only interventional study to date involving a multifactorial approach that was based on a strict policy of reaching risk factor target values has been the STENO 2 (2) study. Intensive care resulted in more than a 50% reduction in cardiovascular events in the intensive group. All target values could not be fully achieved despite intensive efforts, whichwas most difficult regarding glucose control. Integral prevention of diabetic complications of all kinds requires treatment of all modifiable risk factors. Modern diabetes care guidelines strongly suggest an aggressive and multifactorial approach, stressing the priority of lipid and blood pressure control for successful cardiovascular risk reduction. The disparity between the demanding treatment goals and ability to achieve them in everyday practiceis expanding the workload related to type 2 diabetes care. A prominentrole of the general practitioner is expected in the management of cardiovascular risk, and a close cooperation among general practitioners and diabetologists is mandatory in the shared care of type 2 diabetic patients.
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