Treatment of Patients Chronic Coronary Heart Disease and Type 2 Diabetes Mellitus

Abstract

The combination of chronic coronary heart disease and type 2 diabetes mellitus in a patient has high medical importance, because relevance of the problem increases every year. Modern requirements for the provision of high-quality medical care to patients with combined pathology require attentive assessment: we can’t deny the pathophysiological relationship of both diseases. Serious changes that occurred in the treatment tactics in relation to such patients require close attention of the medical community. Modern approaches of the therapy of this group of patients include treatment directions that improve the cardiovascular prognosis (lifestyle changes, anti-platelet therapy, antihypertensive therapy, statins and nonstatin lipid-lowering agents, which are indicated for patients who are difficult to tolerate statin treatment, glucose-lowering drugs), as well as careful management of stable angina syndrome (using of antianginal drugs, assessing the possibilities of revascularization). The therapeutic tactics of the new revision offers promising perspective regimens for taking antiplatelet therapy, lipid-lowering drugs. The new line of glucose-lowering drugs has high cardioprotective properties, reduces the intensity of vascular lesions (vasoprotection), and has renoprotective properties. The strategy of choosing glucose-lowering drugs has also undergone some changes: at the moment it is designated as «differentiated», which implies choosing a drug with the highest organoprotective properties. Achievement of target HbA1C levels in the range of 7.0-8.0 % is associated with the lowest patient mortality rate. In addition, to patients with type 2 diabetes mellitus, especially group with coronary heart disease, advised to minimize episodes of hypoglycemic conditions. Aim of this statement is to discuss in detail progressive approaches in the treatment of patients with chronic coronary heart disease and type 2 diabetes mellitus.