Type 2 diabetes is a significant independent risk factor for cardiovascular diseases (CVD), influenced by factors such as glycemic variability, hypertension, and obesity. Effective treatment requires targeting tight glycemic control while managing all cardiovascular risk factors, avoiding hypoglycemia, and utilizing medications that provide cardiovascular benefits. Emphasis is placed on early use of disease-modifying drugs and addressing endothelial dysfunction to improve patient outcomes.

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

2. prevalence

3. 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

4. Pathogenesis of CVD in type 2 DM

5. 1- type 2 diabetes and atherosclerotic
CVD

6. 2- type 2 diabetes and HF

7. relation between DM and HF

8. 3- type 2 diabetes and Arrhythmia

9. 4- type 2 diabetes and hypertension

10. 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

11. 1- treatment target

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

13. 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

14. •
• 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

15. • 6- use GLDs that decrease IR

16. 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 (

19. new guideline

21. treatment of patients with established ASCVD or at
risk

22. patients with HF