NATURAL-HISTORY OF CARDIOVASCULAR AND RENAL-DISEASE IN PATIENTS WITH TYPE-2 DIABETES - EFFECT OF THERAPEUTIC INTERVENTIONS AND RISK MODIFICATION

Several observational studies document a considerably increased risk o f advanced renal disease, cardiovascular disease, and early mortality in persons with diabetes. Both epidemiologic and observational studies indicate that progression of cardiovascular disease and renal disease is associated not only with high blood glucose levels, but also with hypertension and dyslipidemia. In persons with type 1 diabetes, hypogl ycemic and antihypertensive therapy are important in the prevention of cardiovascular and renal disease. In those with type 2 diabetes, hypo glycemic therapy can help to prevent microvascular disease in the reti na and in the kidney, and recent studies show that antihypertensive tr eatment is important in preventing cardiovascular disease. Thus, a mul tifactorial intervention program is key to preventing complications of hyperglycemia and, equally important, elevated blood pressure and dys lipidemia. (C) 1998 by Excerpta Medica, Inc.