Journal List > J Korean Diabetes > v.20(4) > 1141070

Yu: Management of Cardiovascular Risk Factors in Elderly Diabetes Mellitus Patients

Abstract

Tight control of dyslipidemia and hypertension in elderly diabetic patients aged 65 years or older are considered to be very important for the secondary prevention of cardiovascular disease and control of severe diseases associated with macrovascular complications. In addition, in elderly diabetes with risk factors for cardiovascular disease, it is important to control all of the accompanying risk factors together to accomplish the primary prevention of cardiovascular disease. In elderly diabetic patients, thorough control of blood glucose level by itself prevents macrovascular complications. However, it is recommended to perform tight blood glucose control along with other risk factors in consideration of the function and life of the patient. In particular, insulin resistance progresses before the onset of diabetes mellitus and other risk factors for cardiovascular disease. It is important to suppress and prevent the progression of macrovascular complications.

References

1. Korean Diabetes Association. Elderly diabetes mellitus. 3rd ed. Seoul: Korea Medical Book Publishing Company;2018. p. 13–18.
2. Ko SH, Han K, Lee YH, Noh J, Park CY, Kim DJ, Jung CH, Lee KU, Ko KS. TaskForce Team for the Diabetes Fact Sheet of the Korean Diabetes Association. Past and current status of adult type 2 diabetes mellitus management in Korea: a national health insurance service database analysis. Diabetes Metab J. 2018; 42:93–100.
crossref
3. Engelgau MM, Geiss LS, Saaddine JB, Boyle JP, Benjamin SM, Gregg EW, Tierney EF, Rios-Burrows N, Mokdad AH, Ford ES, Imperatore G, Narayan KM. The evolving diabetes burden in the United States. Ann Intern Med. 2004; 140:945–950.
crossref
4. Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, Thompson TJ. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care. 2001; 24:1936–1940.
5. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018; 17:83.
crossref
6. Dal Canto E, Ceriello A, Rydén L, Ferrini M, Hansen TB, Schnell O, Standl E, Beulens JW. Diabetes as a cardiovascular risk factor: an overview of global trends of macro and micro vascular complications. Eur J Prev Cardiol. 2019; 26(2_suppl):25–32.
crossref
7. Fried LP, Borhani NO, Enright P, Furberg CD, Gardin JM, Kronmal RA, Kuller LH, Manolio TA, Mittelmark MB, Newman A, O'Leary DH, Psaty B, Rautaharju P, Tracy RP, Weiler PG. The cardiovascular health study: design and rationale. Ann Epidemiol. 1991; 1:263–276.
crossref
8. Ferrannini E, Mark M, Mayoux E. CV Protection in the EMPA-REG OUTCOME trial: a “Thrifty Substrate” hypothesis. Diabetes Care. 2016; 39:1108–1114.
crossref
9. Sattar N, McLaren J, Kristensen SL, Preiss D, McMurray JJ. SGLT2 Inhibition and cardiovascular events: why did EMPA-REG Outcomes surprise and what were the likely mechanisms? Diabetologia. 2016; 59:1333–1339.
crossref
10. Doggrell SA. Cardiovascular outcomes with canagliflozin - is it on the CANVAS? Expert Opin Pharmacother. 2018; 19:163–166.
crossref
11. Kim MK, Ko SH, Kim BY, Kang ES, Noh J, Kim SK, Park SO, Hur KY, Chon S, Moon MK, Kim NH, Kim SY, Rhee SY, Lee KW, Kim JH, Rhee EJ, Chun S, Yu SH, Kim DJ, Kwon HS, Park KS. Committee of Clinical Practice Guidelines, Korean Diabetes Association. 2019 Clinical Practice Guidelines for type 2 diabetes mellitus in Korea. Diabetes Metab J. 2019; 43:398–406.
crossref
12. Korean Diabetes Association. Elderly diabetes mellitus. 3rd ed. Seoul: Korea Medical Book Publishing Company;2018. p. 117–122.
13. Park HW, Kang MG, Kim K, Koh JS, Park JR, Jeong YH, Ahn JH, Jang JY, Kwak CH, Park Y, Jeong MH, Kim YJ, Cho MC, Kim CJ, Hwang JY. KAMIR-NIH registry. Long-term prognosis and clinical characteristics of patients with newly diagnosed diabetes mellitus detected after first acute myocardial infarction: from KAMIR-NIH registry. Korean Circ J. 2018; 48:134–147.
crossref
14. Action to Control Cardiovascular Risk in Diabetes Study Group. Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008; 358:2545–2559.
crossref
15. ADVANCE Collaborative Group. Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, Marre M, Cooper M, Glasziou P, Grobbee D, Hamet P, Harrap S, Heller S, Liu L, Mancia G, Mogensen CE, Pan C, Poulter N, Rodgers A, Williams B, Bompoint S, de Galan BE, Joshi R, Travert F. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008; 358:2560–2572.
16. Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S, McCarren M, Vitek ME, Henderson WG, Huang GD. VADT Investigators. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009; 360:129–139.
crossref
17. Holman RR, Paul SK, Bethel MA, Neil HA, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med. 2008; 359:1565–1576.
crossref
18. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA. 1991; 265:3255–3264.
19. Goldberg RJ, Larson M, Levy D. Factors associated with survival to 75 years of age in middle-aged men and women. The Framingham Study. Arch Intern Med. 1996; 156:505–509.
crossref
20. American Diabetes Association. 12. Older adults: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019; 42:Suppl 1. S139–S147.
21. American Diabetes Association. 10. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019; 42:Suppl 1. S103–S123.
22. Prospective Studies Collaboration. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, Qizilbash N, Peto R, Collins R. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a metaanalysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007; 370:1829–1839.
crossref
23. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, Hoes AW, Jennings CS, Landmesser U, Pedersen TR, Reiner Ž, Riccardi G, Taskinen MR, Tokgozoglu L, Verschuren WMM, Vlachopoulos C, Wood DA, Zamorano JL, Cooney MT. ESC Scientific Document Group. 2016 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2016; 37:2999–3058.
crossref
TOOLS
Similar articles