Implications of the global diabetes epidemic

Abstract

The dramatic increase in the prevalence of type 2 diabetes, largely as a result of increasing obesity and sedentary lifestyle, signals an impending public health crisis for the 21 st century. Individuals with type 2 diabetes have a two to four-fold increased risk of cardiovascular disease, evident even before clinical diagnosis of diabetes. Guidelines for the prevention of cardiovascular disease clearly identify the increased risk associated with type 2 diabetes and advocate intensive risk factor management. The atherogenic dyslipidaemia associated with type 2 diabetes, characterised by elevated triglycerides (TG), a low level of high-density lipoprotein cholesterol (HDL-C) and an increase in the number of small, dense low-density lipoprotein (LDL) particles (although LDL-C levels may be normal or only modestly elevated), is a key modifiable risk factor, and warrants early and intensive intervention.