Type diabetes mellitus is the most common metabolic disorder. It is characterized by hyperglycemia and associated with macrovascular, microvascular, and other complications.
It will establish that metabolic control of diabetic patients reduces significantly the risk of developing microvascular complication but have less significant effect in preventing macrovascular complication. On the other hand, intensified intervention involving several risk factor in patients with type 2 diabetes including hyperglycemia, hypertension, obesity and dyslipidemia, demonstrated benefits in terms of both macrovascular and microvascular complications.
Several studies have emphasized the importance of early treatment in diabetes, not only to prevent microvascular complications, but also to prevent CV complications years after the completion of the trial, as has been observed in UKPDS trial after 10 years of observational follow-up, referred to as a "legacy effect".
Relyng on what is mentioned above, targeting glycemic control should be the major target in the management of diabetic patients. However, a target-driven, intensified intervention aimed at multiple risk factors including all the metabolic syndrome parameters should be adapted in patients with type 2 diabetes as early as possible to reduce the risk of both cardiovascular and microvascular complications.