[Overview of cardiovascular risk factors in diabetic patients: focus on hypoglycemia, dyslipidemia, body weight and cardiovascular disease].

: The incidence of type 2 diabetes mellitus continues to grow rapidly, paralleling the overweight and obesity epidemic. Diabetes has long been related to a significant increase in cardiovascular risk profile. Epidemiological studies have documented a 2 to 4-fold increase in cardiovascular mortality and morbidity. Type 2 diabetes is linked to the metabolic syndrome, a cluster of several metabolic risk factors (such as obesity, hypertension and dyslipidemia). Although improved glycemic control has repeatedly been shown to reduce microvascular diabetic complications, uncertainty remains regarding whether any particular glucose-lowering strategy, or specific therapeutic agent, is safe from a cardiovascular standpoint or can actually lower cardiovascular risk. Thus, there remains a strong clinical need for antihyperglycemic drugs that can improve glycemic control without increasing cardiovascular events, which seems to be strictly related to hypoglycemia. The differences between extra-glycemic effects of antidiabetic drugs currently available should be carefully evaluated, thus improving the achievement of therapeutic goals as suggested by national and international guidelines. An ef fective treatment of the concomitant cardiovascular risk factors through cholesterol- and blood pressure-lowering therapies and a weight-control therapeutic approach should also be considered.