In type 2 Diabetes: The Impact Of Lowering Glucose Level On Cardiovascular Risk Is Significant

Abstract

Diabetes type 2 diabetes mellitus is characterized by a high cardiovascular risk, which includes
atherosclerotic cardiovascular disease. Some of the well-known pathophysiologic factors which play a crucial
role include endothelial dysfunction due to oxidative stress and inflammation, hyperglycemia, increased
activity of nuclear factor kappa B, altered macrophage polarization and reduced synthesis of resident
endothelial progenitor cells. Therefore, it is reasonable to suggest that the atherosclerotic disease may
progress more rapidly with increased tendency for unstable plaque formation, culminating in high mortality
from cardiovascular diseases. The main strategies are therefore to prevent or diagnose it at the earliest,
through management of hyperglycaemia and vascular complications. The new strategies for the management
of T2DM are aimed at developing individualized treatment strategies for each patient with the goal of
enhancing glucose lowering effects and minimizing the incidence of hypoglycemia and other side effects as
well as prevention of cardiovascular diseases. New drugs (e. g. GLP-1 RAs, SGLT2is, DPP4is) have effects on
body weight, lipids and blood pressure and also influence endothelium (dis)function, inflammatory markers,
OS biomarkers and SAS. The present review summarizes the results of the main trials focused on the
cardiovascular safety of these drugs from the CV standpoint.