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Early Type 2 Diabetes Mellitus and Sub Clinical Cardiovascular Disease, does Early Intervention prevents the Future Complications ?A Common Soil Hypothesis?

Abhishek Shrivastava

Unlike classical microvascular complications, large-vessel atherosclerosis can precede the development of diabetes, suggesting that rather than atherosclerosis being a complication of diabetes, both conditions have common genetic and environmental antecedents, i.e., they spring from a "common soil." Cardiovascular risk is a continuum of dysglycemia as the disease progresses the relative risk increases, but may studies have suggested that much before the diagnosis of diabetes the relative risk does not differ much. In Patients of Diabetes Subclinical CVD affects >2/3rd of patients of Diabetes Over 2/3rd of asymptomatic patients of T2DM have CAD (over half of which may have significant obstruction) As-CVD and HF manifest many years earlier in DM Extent and Severity of CAD is greater in DM 2/3rd of deaths in DM are due to CVD (As-CVD and HF) Concomitant CKD in DM increases CV mortality by 2.9-fold. Diabetes in South Asians occurs around 10 years earlier than in the Caucasanians. Like diabetes, CAD is also more common in South Asians. MI occurs at a younger age and is associated with premature CAD mortality. In Indians, half of all heart attacks occur before the age of 50 and a quarter before 40. Compared with women, men exhibit higher prevalence of cardiovascular disorders, especially CAD. However, the rate of coronary death is twice as high in women as in men after MI and revascularization procedures. Biography: Dr Abhishek Shrivastava is a practising endocrinologist in India, He has a practising experience of more than 10 years, He has various publications to his name and has been as a faculty in various national as well as regional conferences. He is also serving as an editorial board member in journal of endocrinolgy and metabolism research. He recently received research excellence award for his study on hypogonadism.