Type 2 diabetes mellitus: prevention of macrovascular complications.

Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary heart disease, stroke or peripheral artery disease. Optimal control of elevated blood glucose levels will reduce the symptoms of hyperglycemia and help to prevent the development of complications. In addition, treatment of hypertension and lipid disturbances has been shown to reduce the incidence and severity of vascular complications significantly. The current treatment goals focus on adequate and aggressive treatment of these three risk factors. The central dogma for treatment of blood glucose, blood pressure and cholesterol levels is 'the lower the better'. Ongoing trials evaluate the effect of further lowering these treatment goals and of specific types of medication on cardiovascular events.