Diabetes-new treatments

The organization, which represents more than 100,000 internists, issued new guidelines on how to treat the 18 million Americans with type 2 diabetes.

Simply having diabetes makes a man two to four times more likely to have a heart attack or stroke than someone without the disease. Diabetes makes a woman's risk of a heart attack two to six times greater. Researchers say that's because a diabetic's blood is thicker and more prone to clot.

The new guidelines say diabetics should take cholesterol-lowering statins - even if their cholesterol levels are good - if they have any one of the following health problems: high blood pressure, obesity, smoking, or a family history of heart disease, report abcnews.go.com

According to forbes.com new guidelines from the American College of Physicians (ACP) advise that nearly all diabetics with heart disease or heart disease risk factors - such as high blood pressure, high cholesterol, obesity or smoking - be placed on medications such as Crestor, Lipitor, Pravachol or Zocor.

"Patients with diabetes should realize that controlling their blood sugar is important, but it's not the only aspect of diabetes care that's important," explained ACP spokeswoman Dr. Vincenza Snow. "Their blood pressure and their lipid control is also very important and can have a significant impact on their mortality and on their getting sick."

Experts estimate that nearly two-thirds of people with type 2 diabetes will die of either a heart attack or stroke.

Another major medical group is urging that the majority of America's 18.2 million diabetics be placed on cholesterol-busting statins, to lower their risk for heart attack and stroke.

Traditionally, diabetes treatment has focused on regulating blood sugar levels by careful control of diet or through insulin injections. But researchers have come to understand that controlling sugar really protects only against the destruction of small blood vessels, which can lead to blindness or loss of fingers, toes or limbs. Heart disease is, in fact, the more serious threat. Up to 80 percent of diabetes patients will develop heart problems or die of them, the article said. And Dr. Vijan emphasized that controlling hypertension remained the highest priority. He ranked control of lipids, the fats in the blood stream that can affect coronary health, second, ahead of glucose regulation. Dr. Vijan said the new guidelines called for moderate doses of statins; the largest clinical trial involving diabetics used 40 milligrams of simvistatin, for example. He said researchers were evaluating recently published studies that suggested that high doses of statins might have better results, nytimes.com

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