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World J Diabetes. Aug 15, 2014; 5(4): 444-470
Published online Aug 15, 2014. doi: 10.4239/wjd.v5.i4.444
Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?
Iciar Martín-Timón, Cristina Sevillano-Collantes, Amparo Segura-Galindo, Francisco Javier del Cañizo-Gómez
Iciar Martín-Timón, Cristina Sevillano-Collantes, Amparo Segura-Galindo, Francisco Javier del Cañizo-Gómez, Section of Endocrinology, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid 28031, Spain
Author contributions: Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A and del Cañizo-Gómez FJ contributed equally to this work.
Correspondence to: Dr. Francisco Javier del Cañizo Gómez, Professor of Medicine, Chief of Endocrinology Section, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Avda Gran Vía del Este 80, Madrid 28031, Spain. fjcanizog@salud.madrid.org
Telephone: +34-91-1918000 Fax: +34-91-1918878
Received: November 27, 2013
Revised: January 26, 2014
Accepted: June 20, 2014
Published online: August 15, 2014
Processing time: 253 Days and 20.7 Hours
Abstract

Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Many of these risk factors could be common history for both diabetes mellitus and cardiovascular disease, reinforcing the postulate that both disorders come independently from “common soil”. The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.

Keywords: Type 2 diabetes mellitus; Cardiovascular disease; Dyslipidaemia; Blood pressure; Obesity; Microalbuminuria; Inflammation; Insulin resistance; Postprandial Hyperglycaemia; Homocysteine

Core tip: The objective of this review is to highlight the importance of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.