Cardiovascular Diseases Caused by Diabetes: An Overview of Pathogenesis and Treatment

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in diabetic populations. CVD risk factors such as obesity, dyslipidemia, and hypertension are more common in patients with T2DM. Atherosclerosis and atherothrombosis happen in earlier ages, progress quicker, and are associated with more complications among diabetic patients. The best treatment for coronary artery disease for patients with diabetes mellitus is prevention. The underlying mechanism of coronary heart disease involves chronic immuno-inflammatory, fibro-proliferative, lipid-driven, progressive processes and atherosclerosis. Coronary heart disease (CHD) represents the most common cause of death and disability in the world today. CHD represents the continuum of disease pathologies and has been classified as chronic CHD, acute coronary syndrome and sudden cardiac death. Acute coronary syndromes are spectrum of ischemic myocardial events that range from STEMI, NSTEMI, and unstable angina. Diagnosis is mainly by clinical symptoms, serial ECGs, and cardiac enzyme levels. The management includes reperfusion strategies such as thrombolytic therapy, primary percutaneous coronary intervention (PCI), and pharmacotherapy after reperfusion (antiplatelets, anticoagulants, ACE inhibitors, statins, and beta-blockers). With aggressive secondary prevention measures which include treatment with statins, smoking cessation, weight reduction, dietary modification, diabetic control, and enrolment in cardiac rehabilitation program. Heart failure is a complex clinical syndrome characterized by structural and functional changes in the heart and peripheral vasculature, affecting both systolic and diastolic function. The most common symptoms include exertional dyspnea, orthopnea, fatigue, and nocturnal dyspnea. Other common signs include edema, elevated JVP, S3 gallop, and chest congestion. The diagnosis of heart failure is mainly from history and physical examination confirmed by ECHO and NT-PRO BNP levels. The target of therapy depends on the extent of symptoms, such as lung congestion and edema, which are relieved by loop diuretics. Progressive beneficial impact on remodelling is mostly due to long-term use of beta-blockers and ARNI.