Long-term influence of glycaemic control on cardiovascular risk in NIDDM.

Non-insulin-dependent diabetes mellitus (NIDDM) is a strong risk factor for all manifestations of atherosclerotic vascular disease, coronary heart disease (CHD), cerebrovascular disease and peripheral vascular disease [l]. Atherosclerosis-related mortality in diabetic patients has steadily increased since the beginning of the insulin era up to 70% of total mortality in both main types of diabetes. However, underlying mechanisms for the accelerated atherogenesis in NIDDM have remained poorly understood. Several cardiovascular risk factors typical to patients with NIDDM favour atherogenesis (high total triglycerides, low high-density lipoprotein cholesterol, high prevalence of hypertension and obesity). In spite of that, population-based prospective studies have repeatedly demonstrated that only a small proportion of the excess risk for CHD in NIDDM can be explained by the effects of NIDDM on the levels of cardiovascular risk factors [l]. This strongly sug gests that the excessive occurrence of CHD and