Prevention of Cardiovascular Disease in Patients who have Diabetes119

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Ali A. Jawa and Vivian A. Fonseca

This article examines the evidence in favor or against choosing treatment with insulin secretagogues or sensitizers as the preferred way to prevent cardiovascular events. It should be emphasized that most patients eventually will be treated with a combination of therapies; therefore, much of the discussion may not be relevant. Conversely, combination of two sensitizers may have added effects. Also, retrospective data suggest that a combination of sulfonylurea and metformin may be associated with increased cardiovascular events. Nevertheless, it is important to recognize the relative value of these different agents as we choose complex therapeutic regimens.

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