Management strategy of diabetic macrovascular disease: From intensive glycemic control to harmonious equipoise

Etiology of diabetic macrovascular disease is complex. Although diabetes is closely associated with atherosclerotic cardiovascular diseases (ASCVD), their pathogeneses are different. Recent clinical trails showed that multiplex intervention including anti-hyperglycemia in combination with lipids adjusting and blood pressure lowering procedures significantly reduced the events of ASCVD, but intensive gljcemic control alone did not. To prevent the ongoing diabetic macrovascular lesion, comprehensive evaluation of macrovascular damage and risks is very important. In addition, early treatment of hyperglycemia will blockade the hyperglycemia-induced metabolic memory and ameliorate vascular complications. Management of diabetic macrovascular disease should emphasize the strategy of simultaneously modifying all of the risk factors, harmonious equipoise of intervention and tailoring treatment. Key words: Diabetes mellitus;  Macrovascular diseases;  Management strategy