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Beneficial and Detrimental Effects of Glycemic Control on Cardiovascular Disease in Type 2 Diabetes

  • Diabetes and Cardiovascular Disease (S Malik, Section Editor)
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Abstract

Epidemiological data demonstrates that improved regulation of blood glucose correlates with better cardiovascular (CV) outcomes. Conversely, some interventional studies have demonstrated that tight glycemic control has no benefit or can even result in worse CV outcomes. These conclusions parallel the paradox that glycemic control has proven beneficial for microvascular outcomes, while few studies have demonstrated significant macrovascular benefits. This imprecise understanding conveys the need to better comprehend the mechanisms of glycemic control and its impact on CV disease. Such variations in data also require a more comprehensive approach to diabetes and CV disease in which multiple biomarkers such as low density lipoprotein (LDL), low adiponectin, elevated C-reactive protein (CRP) and well established clinical parameters such as high blood pressure, weight, and functional status are incorporated into clinical decision making. Reliance on one parameter in isolation such as glycemic control and one biomarker such as HbA1C does not provide an accurate assessment of CV outcomes.

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Disclosure

Conflicts of interest P.R. Taub: none; E. Higginbotham: none; R.R. Henry: has board membership with Amylin Pharmaceuticals, Boehringer Ingelheim, Lilly Pharmaceuticals, Merck Pharmaceuticals, Novo Nordisk, Gilead Pharmaceuticals, Intarcia Pharmaceuticals; has been a consultant for Amgen Pharmaceuticals, Boehringer Ingelheim, Sanofi Aventis, Merck Pharmaceuticals, Gilead Pharmaceuticals, Isis Pharmaceuticals; has received grant support from Amylin Pharmaceuticals, Amgen Pharmaceuticals, Bristol Myers Squibb/AstraZeneca, Johnson & Johnson/Jenssen, Eli Lilly Pharmaceuticals, Sanofi Aventis; and has received payment for development of educational presentations including service on speakers’ bureaus from Boehringer Ingelheim/Lilly Pharmaceuticals

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  1. University of California, San Diego, San Diego, CA, USA

    Pam R. Taub, Erin Higginbotham & Robert R. Henry

  2. Veterans Affairs Medical Center, La Jolla, CA, USA

    Robert R. Henry

  3. UCSD Division of Cardiology, Sulpizio Cardiovascular Center, 9444 Medical Center Drive, Mail Code 7411, La Jolla, CA, 92037-7411, USA

    Pam R. Taub

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Taub, P.R., Higginbotham, E. & Henry, R.R. Beneficial and Detrimental Effects of Glycemic Control on Cardiovascular Disease in Type 2 Diabetes. Curr Cardiol Rep 15, 332 (2013). https://doi.org/10.1007/s11886-012-0332-4

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