Cardiovascular Risk in Obese Type 2 Diabetes Mellitus Patients

Abdominal obesity and Type 2 diabetes mellitus represent a frequent association, leading to an increased morbidity and mortality from atherogenic macrovascular disease. The key feature which links visceral obesity, Type 2 diabetes mellitus and cardiovascular risk is considered to be insulin resistance. It induces a cluster of metabolic, vascular, prothrombotic anomalies, known as metabolic syndrome. The cardiovascular risk related to metabolic syndrome consists of an amplified action of each component, leading to high and early probability of developing atherosclerotic pathology. As demonstrated by clinical trials, most of the newly-diagnosed obese Type 2 diabetic patients have a high cardiovascular risk due to the presence of cardiovascular risk factors. To reduce cardiovascular risk, an aggressive approach is required, in terms of risk factor identification, global risk evaluation, targeted and multifactorial interventions. Structured programme as: therapy, education, monitoring, evaluation should be applied. Weight loss is a major therapeutic goal. Lifestyle optimization, through hypocaloric diet and physical activity and specific medication for obesity, are methods to be considered.