¿La diabetes tipo 2 debería diagnosticarse y tratarse como una enfermedad cardiovascular?

Abstract

There are an increasing body of evidences from clinical trials that associate type 2 diabetes with cardiovascular disease, especially since the majority of those patients die from a cardiovascular disease and macrovascular complications. Recent prospective studies have shown that achieving a good metabolic control by decreasing fasting plasma glucose and glycosylated hemoglobin is possible to prevent the development of microvascular complications of type 2 diabetics. Nevertheless, other epidemiological studies have stressed the importance of postprandial hyperglycemia and his role as an independent risk factor of cardiovascular morbidity and mortality. People affected by the so-called metabolic syndrome (hypertension, dyslipidemia, central adiposity, insulin resistance and hyperisulinism) have a high risk to develop a cardiovascular disease, even without been affected by type 2 diabetes but only with impaired glucose tolerance. This showing that the cardiovascular risk is increasing at the same time as the entire glycemic levels (both mealtime glucose spikes and fasting plasma glucose). The current therapeutical choices to correct the metabolic alterations of diabetes should also prevent the appearance of long-term macrovascular complications of the disease. Nateglinide, a rapid-onset, short-acting insulin secretion enhancer, which acts to effectively reduce mealtime glucose spikes, could offer a good therapeutical option to manage patients with type 2 diabetes.