diabetes and cardiovascular disease .pptx

Pathogenesis and causes of cardiovascular disease in type 2diabetes

1. type 2 diabetes and cardiovascular diseases Professor / Mohammed Ahmed Bamashmos Professor of Internal Medicine and Endocrinology

2. prevalence

3. risk factors 1- type 2 DM is one of major four independent risk factors of CVD 2- Diabetes and other associated CVD risk factors - Glycemic variability - Hypoglycemic complication - Age and gender - Hypertension - Insulin resistance - obesity - Dyslipidemia - Endothelial dysfunction - inflammation

4. Pathogenesis of CVD in type 2 DM

5. 1- type 2 diabetes and atherosclerotic CVD

6. 2- type 2 diabetes and HF

7. relation between DM and HF

8. 3- type 2 diabetes and Arrhythmia

9. 4- type 2 diabetes and hypertension

10. treatment ; factors that should be considered ; 1- treatment target 2- tight glycemic control 3- Ovoid glycemic variability 4 – Ovoid hypoglycemic complication 5- Ovoid weight gain 6- treat diabetic dyslipidemia 7- reverse endothelial dysfunction 8- use drugs that have long term CV beneficial effect ( effect in reducing MACE ) 9- early use of Disease Diabetic Modifying drugs

11. 1- treatment target

12. tight glycemic control Important ; ; any increase in HbA1C by 1 is associated with increased CV mortality by 11-16%

13. treat all CV risk factors in type 2 diabetes 1- Avoid hypoglycemia ; adverse effect of hypoglycemia ; - increased inflammation and CRP - Endothelial dysfunction - Sympatho adrenal response and increased adrenaline 2- use drugs that has effect in both FBS , PPBS and GV ; adverse effect of GV ; endothelial dysfunction , thrombosis and increased plaque instability

14. 3- use GLDs that improve dyslipidemia and decrease BP 4- use GLDs that overcome endothelial dysfunction; endothelial dysfunction leads to ; - vasoconstriction , inflammation and thrombosis 5- use GLDs that decrease body weight ; effect of weight gain ; - insulin resistance - hyperglycemia - increased BP - inflammation , dyslipidemia - endothelial dysfunction

15. 6- use GLDs that decrease IR

16. 7 use GLDs that ; - decrease inflammation - decrease coagulation 8- Early use of diabetic diseases modifying drugs irrespective of glycemic control as ( SGLT2I, GLP1RA , DPPT4I , and Metformin ) 9- use GLDs that has beneficial effect in reducing MCVE (

17. new guideline

18. treatment of patients with established ASCVD or at risk

19. patients with HF