Effects of oral antihyperglycemic agents in modifying macrovascular risk factors in type 2 diabetes

Management of patients with type 2 diabetes should focus on decreasing the excess macrovascular disease with which it is associated as well as prevent ing or minimizing microvascular disease. Near-normoglycemic control can red uce microvascular disease. Reducing macrovascular disease requires concomit ant management of the cardiovascular risk factors (components of the insuli n resistance syndrome) associated with type 2 diabetes. The first phase of such treatment is to identify the effects that the various drugs used to tr eat the hyperglycemia are likely to have on these associated cardiovascular risk factors. Appropriate combinations of antihyperglycemic agents should be selected for specific patients to help achieve good glycemic control and produce beneficial, or at least nondetrimental, effects on cardiovascular risk.