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      Glucose and LDL lowering: the need for intensive therapy.

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      Current vascular pharmacology

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          Abstract

          In almost every epidemiological analysis so far performed a strong correlation always emerges between degree of hyperglycemia and risk of both micro- and macrovascular complications. However, whereas lowering plasma glucose levels by intensive treatment has proven to reduce the risk of development of retinopathy, nephropathy and neuropathy, the effect on macrovascular complications has remained quite doubtful. Multiple factors may have concurred to this negative findings including long duration of diabetes, poor pre-existing glycaemic control, potentially inadequate anti-diabetes drugs. Another potential explanation is that, given the high cardiovascular risk of the diabetic patients they were already aggressively treated as far as their cardiovascular risk factors are concerned. The annual mortality in these diabetic cohorts was, indeed, incredibly close to that of the non-diabetic population. These considerations along with the results of multiintervention studies, such as the Steno-2, supports the need for multifactorial intensive needs, definitely including glucose and lipid lowering.

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          Author and article information

          Journal
          Curr Vasc Pharmacol
          Current vascular pharmacology
          1875-6212
          1570-1611
          Nov 2012
          : 10
          : 6
          Affiliations
          [1 ] Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Italy. stefano.delprato@med.unipi.it
          Article
          CVP-10-6-687
          23259554
          9a5a62f7-527f-4a6d-8cd2-929f76e7ac88
          History

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