Hyperglycemia, Hypertension, and Dyslipidemia in Type 2 Diabetes Mellitus: Goals for Diabetes Management

Type 2 diabetes mellitus (DM) is frequently associated with other major cardiovascular risk factors, namely, hypertension and hypertriglyceridemia; low levels of high-density lipoprotein cholesterol and elevated levels of low-density lipoprotein cholesterol; the likely presence of metabolic syndrome; and the spectrum of nontraditional risk factors, including inflammation, hypercoagulability, and vascular endothelial abnormalities, that often accompany insulin resistance. Patients with type 2 DM, therefore, are at an increased risk for cardiovascular disease (CVD) and mortality. Along with the prevention of microvascular complications, the prevention of CVD events and mortality are major goals of diabetes therapy. Research has helped to establish targets for the treatment of the 3 major risk factors for type 2 DM–hypertension, hyperglycemia, and dyslipidemia—and clinical guidelines agree about the need to monitor and treat these risk factors. Lifestyle modification is recommended as a first-line approach to risk reduction; however, many patients will also require pharmacotherapy to achieve their treatment goals.