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The Cardiovascular Consequences of Type 2 Diabetes Mellitus

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Diabetes and Exercise

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Atherosclerosis is the leading cause of death among individuals with type 2 diabetes, accounting for 80% of all mortality among affected individuals. The prediabetic state of insulin resistance, with its accompanying central adiposity, dyslipidemia, and hypertension, is thought to contribute to the development of cardiovascular disease in type 2 diabetes. This chapter summarizes (1) the pathophysiology of the prediabetic state, (2) use of the metabolic syndrome as a clinical proxy for the presence of insulin resistance, and (3) the prediabetic state (metabolic syndrome) as a predictor of cardiovascular disease, highlighting hypertension, dyslipidemia, and impaired glucose metabolism as the strongest predictors. Dyslipidemia, hypertension, and hyperglycemia are highlighted as important targets in cardiovascular disease prevention in type 2 diabetes. Current controversies regarding the glycemic target for cardiovascular disease prevention in diabetes are discussed in light of recently published clinical trials. Other direct cardiovascular effects of diabetes are highlighted, including left ventricular dysfunction, endothelial dysfunction, arterial stiffness, and systemic inflammation.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Welch Center for Prevention, Epidemiology, and Clinical Research, Departments of Medicine and Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Sherita Hill Golden

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  1. Sherita Hill Golden
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Editors and Affiliations

  1. Divisions of General Internal Medicine and Cardiology, Department of Medicine, University of Colorado Denver, Aurora, CO, USA

    Judith G. Regensteiner PhD

  2. Division of Endocrinology Metabolism and Diabetes, Department of Medicine, Aurora, CO, USA

    Jane E.B. Reusch MD

  3. Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Kerry J. Stewart EDD

  4. Joslin-Beth Israel Deaconess Foot Center, Microcirculation Laboratory, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Aristidis Veves MD, DSc

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Golden, S. (2009). The Cardiovascular Consequences of Type 2 Diabetes Mellitus. In: Regensteiner, J.G., Reusch, J.E., Stewart, K.J., Veves, A. (eds) Diabetes and Exercise. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-59745-260-1_5

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