:
The globalization of the Western lifestyle has resulted in a dramatic increase of diabetes mellitus, a complex, multifactorial disease. Diabetes mellitus is a condition often associated with disorders of the cardiovascular system. It is well established that three quarters of diabetics, aged over 40, will die from cardiovascular disease and are more likely than non-diabetics to die from their first cardiovascular event. Therefore, risk stratification is necessary to individualize treatment. Age above 40 years, diabetes diagnosis of more than 10 years, the presence of a first degree family history with premature CHD, male gender, high blood pressure, LDL above 100 mg/dl, low renal function, microalbuminuria, presence of non-alcoholic fatty liver disease, obstructive sleep apnea, erectile dysfunction and specially metabolic syndrome, chronic hyperglycemia and severe hypoglycemia are conditions that increase cardiovascular risk.
:
Several models have been developed in order to assess cardiovascular risk in people with and without diabetes. Some of them have been proven to be inadequate while others are widely used for years. An emerging way of risk assessment in patients with diabetes mellitus is the use of biomarkers but a lot of research needs to be done on this field in order to have solid conclusions.
Introduction:
Cardiovascular, together with renal disease, claims a significant proportion of morbidity and mortality in association with type 2 diabetes mellitus (T2DM) and obesity. To improve on the long-term renal and cardiovascular outcome, there is the incorporation of bariatric surgery (BS), which seems to be a pivotal intervention.
Areas explored:
Cohort studies and randomized controlled trial (RCT) research of BS among patients with T2DM, are investigated by screening, then information on renal effects and cardiovascular outcome gathered. Metabolic surgery (MS) and BS reduce both mortality and the risk of cardiovascular disorder, chronic kidney diseases and albuminuria. MS refers to a surgical approach whose primary intent is the control of metabolic alterations/hyperglycemia in contrast to BS which is a mere weight-reduction therapy. Patients suffering from poor glycaemic control and other macro and micro-vascular diseases will benefit from a surgical approach. The approach implicates hypertension glomerular remission, gut microbiota shift, reduced renal inflammation and fewer instances of chronic cardiac remodelling.
Conclusion:
MS is beneficial where the main aim is to attain a significant and long-lasting weight loss results. The RCTs have depicted the superiority which surgical mechanisms hold over medically based therapy, for enhancing glycaemic control, and achieving remission of diabetes. This type of surgery improves life quality, reduces incidences of other obesity and diabetes relating diseases like microvascular illness, sleep apnea, fatal disorder, and fatty liver disease.
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