Via practica 6/2015

Cardiovascular risk in diabetics

Cardiovascular disease (CVD), particularly myocardial infarction and acute stroke, is the leading cause of death worldwide. According to Health Organisation (WHO) CVD is every year responsible for some 17 millions of deaths. Diabetic women are at particularly high risk of CVD; diabetes eliminates the usual female advantage for coronary disease mortality. Mechanisms linking pre-diabetes and type 2 diabetes with CVD has been extensively reviewed. Insulin resistance and postprandial glycemia (PPG) are likely to explain a major part of enhanced atherothrombosis in diabetes type 2. Incretins, recently approved class of therapeutic agents for the treatment of type 2 diabetes, GLP-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors (DPP-4i), exert their actions through potentiation of incretin receptor signaling and recovery “ incretin effect”. New prandial GLP-1 RA (lixisenatide) therapy is characterized with low risk of hypoglycemia and improved control of PPG, both effects could be a mechanism linking effective treatment of type 2 diabetes and reduction of cardiovascular risk.

Keywords: CVD, gender differences in cardiovascular risk, insulin resistance, PPG, GLP-1 receptor agonists.