Itinéraire thérapeutique du diabétique de type 2 : quel impact des variations pondérales sur le risque cardiovasculaire ?

In this review, the last data of the literature are analyzed to study the relations between weight, glycemic control and cardiovascular risk. The Swedish register of type 2 diabetic patients shows that a weight gain of one unit of BMI (Body mass index) increases significantly the vascular risk of 13%, an augmentation almost identical to a reduction obtained with a decline of 1% of HbA1c level. Several studies on the cardiovascular risk of diabetic patients produced similar data and underline the importance of maintaining the objective of weight reduction as an important point of the therapeutic strategy for these patients. Intervention studies to demonstrate the effect of the weight loss on the prevention of the cardiovascular events are in progress. This therapeutic objective is difficult to achieve or to maintain and has to use tools exceeding the simple dietetic approach to refer aspects of human sciences transposed on the medical world. In conclusion, everything must be made to avoid as much as possible a weight gain by the use of treatment with a neutral or positive effect on the weight excess within the limits of their efficiency.