La diabetes mellitus tipo 2 como enfermedad cardiovascular

Diabetes mellitus, and in particular type-2 diabetes mellitus, which accounts for around 90% of cases, is a major public health problem, as much because of its high and increasing prevalence, as because of its cardiovascular implications. Atherosclerotic processes are accelerated by hyperglycemia and insulin resistance. Obesity is a predisposing factor for type-2 diabetes mellitus, hypertension, dyslipidemia and atheromatosis, and is associated with insulin resistance and proinflammatory responses that result in carbohydrate intolerance and an atherogenic profile. Endothelial dysfunction and cell adhesion molecules have only been recognized as risk factors in the last few years. Moreover, they appear to play an important role in the conjunction of hyperglycemia and atherosclerosis. The incidence of heart disease is greater in patients with hyperglycemia and diabetes mellitus, due to both coronary disease and cardiomyopathy. At present, there are numerous drugs that target atherosclerosis or hyperglycemia, which can be early or late manifestations, respectively, in the natural history of type-2 diabetes mellitus. Consequently, morbidity and mortality have declined significantly in recent decades.