Assessing cardiovascular risk factors and selecting agents to successfully treat patients with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM), obesity, and cardiovascular disease (CVD) share a common pathogenic mechanism. The prevalence of each of these conditions is increasing at an alarming rate. Despite the availability of several treatment options for patients with T2DM and the use of intensive regimens combining several antidiabetic drugs, less than half of all patients reach a target glycosylated hemoglobin level of less than 7%. Given the rapid increase in the number of patients with T2DM and obesity, as well as the CVD morbidity and mortality associated with this burden, efforts must be made to change the course of disease. The author reviews clinical trial data on the effect of glucose control on CVD risk, the selection and timing of antihyperglycemic agents, the management of associated CVD risk factors, and strategies to improve patient adherence and acceptance-with the goal of assisting physicians in selecting appropriate management strategies for their patients with T2DM.