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Controversies in the cardiovascular management of type 2 diabetes.
MedLine Citation:
PMID:  21106556     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In patients with type 2 diabetes mellitus, intense control of blood pressure, lipids and glucose, aiming at theoretically ideal values, is bought at a cost. Intense blood pressure control has renal complications. Intense lipid control, thus far, has worked for reduction of low-density lipoprotein-cholesterol, paradoxically at the cost of a small increase in new diabetes. Intense control of glycaemia generally requires insulin added to oral agents, which is consistently accompanied by weight gain, while increased hypoglycaemia has a long-term risk of cerebral damage. Intense glycaemic control has not consistently reduced mortality, whereas a strategy based on tight control of lipids and blood pressure with modestly tight glucose control has succeeded. Looking to the future, incretin mimetics may come to the fore as prime agents because they can reduce weight and glycaemia with little significant hypoglycaemia, thereby making tight glucose control easier to achieve.
Authors:
Lionel H Opie; Derek M Yellon; Bernard J Gersh
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Publication Detail:
Type:  Journal Article     Date:  2010-11-23
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  97     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  6-14     Citation Subset:  AIM; IM    
Affiliation:
The Hatter Cardiovascular Institute, University College London Hospital and Medical School, 67 Chenies Mews, London WC1E 6HX, UK; d.yellon@ucl.ac.uk.
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