Oral treatments for type II diabetes in patients with cardiovascular disease.

The incidence of type II diabetes mellitus is rising rapidly, both in the United States and worldwide. Often, the disease is first diagnosed by cardiologists during an evaluation for coronary or peripheral vascular disease. It is therefore important to understand the basic pathophysiology of insulin resistance, its role in the development of type II diabetes, and its association with accelerated atherosclerosis. An appreciation of when to begin testing for diabetes, how to make the diagnosis, and what treatment strategy to choose is imperative. While there are as yet little randomized data to guide hypoglycemic therapy as it pertains to reducing cardiovascular risk, evidence is accumulating that treatment of diabetes will have an impact on cardiovascular outcomes.