Borys Shevchuk / Fotolia
While most patients with diabetes worry about the microvascular complications, the number one cause of death is from cardiovascular (CV) disease. When you ask a patient what scares them the most about diabetes you will typically hear things like “going blind,” “getting put on dialysis,” or “having an amputation.” These are all serious and real risks of long-standing diabetes, so this fear is valid. However, 84% of people with diabetes will die from a heart attack or stroke. These real complications are not considered by many patients to be related to diabetes. Since CV disease is the biggest threat to patients with diabetes, time and attention should be focused on reducing a patient’s CV risk. One step providers take to minimize CV risk is to address the risk factors in order of their severity. While most doctors think about glucose lowering, this only has a secondary role in CV risk reduction. Hypertension treatment, followed by lipid treatment with statins, provides more "bang for the buck" in terms of cardiovascular risk. That is only to say: Remember to address all three items. Anytime you can use an agent that reduces blood pressure and glucose levels you could get even more benefit.