Diabetes mellitus and coronary heart disease.

Diabetes mellitus, especially type 2 diabetes, is a growing concern in America. Longitudinal trends show that obesity is more prevalent than in the past, and the incidence of type 2 diabetes is also increasing. Type 2 diabetes typically doubles the CHD risk in men and triples the risk in women. Intervening to control lipid levels and blood pressure has been shown to be especially helpful in preventing CHD, but the impact of better glycemic control on CHD risk is less convincing, especially in clinical trials. Revascularization studies in diabetics show that coronary bypass surgery is related to better outcomes than angioplasty procedures.