Diabetes mellitus and diabetes-associated vascular disease

Trends Endocrinol Metab. 2001 Jul;12(5):225-30. doi: 10.1016/s1043-2760(01)00391-5.


Diabetes-related cardiovascular disease remains the leading cause of death in patients with type 2 diabetes. Hypertension is common among diabetics and has the same pathogenetic mechanisms as insulin resistance, in which the activated renin-angiotensin system contributes to the emerging high blood pressure and hyperglycemia. Hyperglycemia is one of the triggering factors for vascular dysfunction and clotting abnormalities and, therefore, for accelerated atherosclerosis in diabetes. Glycated hemoglobin levels, as a reflection of the degree of glycemia, are strongly associated with the risk of cardiovascular disease in diabetics and in the general population. Tight glycemic control, the treatment of dyslipidemia and raised blood pressure, in addition to the use of antiplatelet therapy, all powerfully reduce the risks associated with diabetes. Furthermore, angiotensin-converting enzyme inhibitors might offer additional cardioprotection to diabetics above that provided by blood pressure reduction.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Arteriosclerosis / complications
  • Arteriosclerosis / drug therapy
  • Arteriosclerosis / metabolism
  • Arteriosclerosis / physiopathology
  • Blood Coagulation
  • Blood Platelets / metabolism
  • Diabetes Complications*
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / physiopathology
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / metabolism
  • Hyperglycemia / physiopathology
  • Hypertension / complications
  • Hypertension / drug therapy
  • Hypertension / metabolism
  • Hypertension / physiopathology
  • Insulin Resistance
  • Lipoproteins / metabolism
  • Vascular Diseases / complications*
  • Vascular Diseases / drug therapy
  • Vascular Diseases / metabolism
  • Vascular Diseases / physiopathology


  • Angiotensin-Converting Enzyme Inhibitors
  • Lipoproteins