type 2 diabetes and cardiovascular diseases
Professor / Mohammed Ahmed Bamashmos
Professor of Internal Medicine and Endocrinology

prevalence

risk factors
1- type 2 DM is one of major four independent risk factors of CVD
2- Diabetes and other associated CVD risk factors
- Glycemic variability
- Hypoglycemic complication
- Age and gender
- Hypertension
- Insulin resistance
- obesity
- Dyslipidemia
- Endothelial dysfunction
- inflammation

Pathogenesis of CVD in type 2 DM

1- type 2 diabetes and atherosclerotic
CVD

2- type 2 diabetes and HF

relation between DM and HF

3- type 2 diabetes and Arrhythmia

4- type 2 diabetes and hypertension

treatment ;
factors that should be considered ;
1- treatment target
2- tight glycemic control
3- Ovoid glycemic variability
4 – Ovoid hypoglycemic complication
5- Ovoid weight gain
6- treat diabetic dyslipidemia
7- reverse endothelial dysfunction
8- use drugs that have long term CV beneficial effect ( effect in reducing
MACE )
9- early use of Disease Diabetic Modifying drugs

1- treatment target

tight glycemic control
• Important ; ; any increase in HbA1C by 1 is associated with increased CV mortality by
11-16%

treat all CV risk factors in type 2
diabetes
1- Avoid hypoglycemia ;
adverse effect of hypoglycemia ;
- increased inflammation and CRP
- Endothelial dysfunction
- Sympatho adrenal response and increased adrenaline
2- use drugs that has effect in both FBS , PPBS and GV ;
adverse effect of GV ; endothelial dysfunction , thrombosis and increased
plaque instability

•
• 3- use GLDs that improve dyslipidemia and decrease BP
4- use GLDs that overcome endothelial dysfunction;
endothelial dysfunction leads to ;
- vasoconstriction , inflammation and thrombosis
5- use GLDs that decrease body weight ;
effect of weight gain ;
- insulin resistance
- hyperglycemia
- increased BP
- inflammation , dyslipidemia
- endothelial dysfunction

• 6- use GLDs that decrease IR

7 use GLDs that ;
- decrease inflammation
- decrease coagulation
8- Early use of diabetic diseases modifying drugs irrespective of
glycemic control as ( SGLT2I, GLP1RA , DPPT4I , and Metformin )
9- use GLDs that has beneficial effect in reducing MCVE (

new guideline

treatment of patients with established ASCVD or at
risk

patients with HF