Diabetes Mellitus: Beyond Glycemic Control to Cardiovascular Risk

Abstract

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from insulin resistance, impaired insulin secretion, or both. Accumulating epidemiological and clinical evidence has established diabetes mellitus as a major determinant of cardiovascular morbidity and mortality. The concept of diabetes as a cardiovascular risk equivalent implies that individuals with diabetes, even without prior cardiovascular events, possess a cardiovascular risk comparable to non-diabetic individuals with established cardiovascular disease. This review summarizes the evidence supporting this concept, elucidates the underlying pathophysiological mechanisms linking diabetes and cardiovascular disease, and highlights the clinical implications for prevention and management. Recognition of diabetes as a cardiovascular risk equivalent emphasizes the need for early and aggressive cardiovascular risk reduction strategies.