Epidemiology of Cardiovascular Disease in Type 2 Diabetes Mellitus

Type 2 diabetes is a major and accelerating public health challenge. Type 2 diabetes is increasingly found to be a heterogeneous condition, where risk of cardiovascular disease that traditionally has been estimated at 2–4 times that of the nondiabetic population. Cardiovascular (CV) risk factors such as obesity, hypertension and dyslipidemia are common in patients with DM, placing them at increased risk for cardiac events. In addition, many studies have found biological mechanisms associated with DM that independently increase the risk of CVD in diabetic patients. Therefore, targeting CV risk factors in patients with DM is critical to minimize the long-term CV complications of the disease. Epidemiological studies have been powerful tools to study this phenomenon, providing data on prevalence and incidence rates in diverse populations and uncovering risk factors. This writing group has attempted to describe the scope of the problem based on current data. This article predicts that novel insight into diabetes pathogenesis would come from biochemical and genetic epidemiology studies. It also predicts that type 2 diabetes could be prevented by healthy lifestyle change. The challenge now is for us to translate these insights into effective strategies for the prevention of the modern epidemic of diabetes and vascular disease.