Cardial consequences in diabetes mellitus

Cardial Consequences in Diabetes Mellitus Diabetes mellitus as a disease oo f epidemiological impact leads to diabetic cardiopathy by modulation of myo cardial, vascular and metabolic components. This includes the development o f a coronary microangiopathy and a decrease of diastolic and systolic funct ion of the left ventricle as well as the development of an autonomic diabet ic neuropathy. Patients with diabetes show an increased mortality concernin g cardiovascular events. They more often suffer from myocardial infarction as non-diabetics mostly with a more serious course. Moreover, the post-infa rction course is affected with a worse prognosis as in non-diabetics. For diagnosis of cardial involvement in diabetes electrocardiographic and e chocardiographic procedures are of use. Special tests of the autonomic func tion complete the diagnostic ensemble. An early therapy with ACE=inhibitors and beta blocking agents as well as a strong diabetes therapy, in particular with insulin, can influence the mort ality favorably. Moreover, the diagnosis and therapy of additional cardiova scular risk factors (arterial hypertension, dyslipidemia) are very importan t, because these are correlated with a for diabetic patients markedly incre ased risk of mortality. The clinical relevance of the term diabetic cardiopathy is justified by the 6 factors: macroangiopathy, microangiopathy, disturbances of the myocardia l metabolism, myocardial fibrosis, autonomic diabetic neuropathy and distur bances of the coagulability. Diagnostic and therapeutic goals are discussed .