Weighty Matters Balancing Weight Gain with Cardiovascular Risk among Patients with Type 1 Diabetes Mellitus on Intensive Insulin Therapy
ABSTRACT Type 1 diabetes, characterized by a deficiency of insulin production due to damaged pancreatic beta cells, is associated with a 10-fold increase in the risk of cardiovascular disease as compared to the general population.(1,2) Intensive insulin therapy, whether administered by multiple daily injections or continuous infusion via a pump, is the cornerstone of glycemic control in the patient with type 1 diabetes.(3) Most of what we know regarding the benefits of intensive insulin therapy is derived from the Diabetes Control and Complications Trial (DCCT), a trial of patients with type 1 diabetes who were randomized to either intensive or conventional insulin treatment.
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ABSTRACT: Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM.Cardiology Clinics 08/2014; DOI:10.1016/j.ccl.2014.04.001 · 1.06 Impact Factor
Medicina Clínica 12/2013; 141(11):482–483. DOI:10.1016/j.medcli.2013.04.024 · 1.25 Impact Factor