Diabetic Cardiology

Cardiovascular disease is the most common cause of death in people with diabetes. Interest in the assessment and treatment of heart disease has been reawakened because of many factors, including the results of several multi-centre studies. The UKPDS showed that treatment of Type 2 diabetes did not reduce cardiovascular end-points significantly, but that aggressive treatment of blood pressure could do so. The more recent PROactive study showed that treatment with pioglitazone could reduce myocardial infarctions and strokes in diabetic patients with previous myocardial infarction or stroke. In addition, sub-group analysis from several large cardiovascular trials has shown that treatment with statins, anti-platelet therapy, ACE inhibitors and other drugs will also reduce cardiovascular events in people with diabetes. The DIGAMI studies on the use of intravenous insulin infusion at the time of myocardial infarction stimulated a large number of discussion papers on the best treatment of MI and acute coronary syndromes in the diabetic patient. This book reviews the evidence from such trials and looks at developing topics in diabetes and cardiovascular disease from a largely cardiological perspective. It covers both pharmacological and non-pharmacological interventions and also considers both prevention and treatment options, including the management of coronary heart disease, congestive cardiac failure, hypertension, stroke disease and peripheral vascular disease. With heart disease increasingly in the news related to diabetes, and rising numbers of patients with these co-morbidities, this book will be essential reading for healthcare professionals engaged in the care of patients with diabetes and associated cardiovascular disease.