الفهرس 
Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes Pathophysiology of diabetes mellitusmellitus mellitus mellitusmellitusmellitusOnly 14 pages are availabe for public view
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Abstract
Diabetes is an important chronic disease in which the incidence is globally increasing and so considered as an epidemic. The World Health Organization (WHO) estimated that there were 30million people who had diabetes worldwide in 1985. This number increased to 135 million by 1995 and reached 217 million in 2005. By the year 2030 WHO predicts this number will increase to at least 366 million. This growth in diabetes prevalence, driven principally by an increased prevalence of type 2 diabetes (T2D), is occurring in both developing and developed countries. The incidence of type 1 diabetes (T1D) is also increasing in parallel to that of T2D worldwide. Individuals with diabetes and with chronically poor metabolic control can experience microvascular and macrovascular complications leading to a significant burden for the individual and for the society. This burden includes direct costs of medical care and indirect costs, such as loss of productivity, which result from diabetes-related morbidity and premature mortality . Health care expenses for people with diabetes is more than double of that for people without diabetes; the direct and indirect expenditures attributable to diabetes in 2007 in the USA were conservatively estimated at $174 billion, with slightly more spent on chronic complications attributable to diabetes than on diabetes care itself . Cardiovascular diseases (CVD) are the most prevalent cause of mortality and morbidity among people with T2D and T1D. In 2004, in the USA the presence of CVD was found in 68% and 16% of deaths related to diabetes among people older than 65 years, respectively. Adult people with diabetes present rates of mortality due to heart disease and stroke from two to four times higher than those without diabetes . It has been stated that patients with T2D without a previous history of myocardial infarction have the same risk of coronary artery disease (CADs) as non-diabetic subjects with a history of myocardial infarction; this has led the National Cholesterol Education Program to consider diabetes as a coronary heart disease risk equivalent. However, there is still some uncertainty as to whether the cardiovascular risk conferred by diabetes is truly equivalent to that of a previous myocardial infarction . In general, patients with diabetes aggregate other comorbidities such as obesity, hypertension, and dyslipidemia which also contribute to increase the risk for CVD. In the period of 2005 to 2008, the American Diabetes Association (ADA) estimated that 67% of people with diabetes older than 20 years presented blood pressure levels ≥140/90mmHg or were using antihypertensive drugs . Although there is strong evidence that supports both the efficacy and cost effectiveness of programs directed towards an improvement of glycemic control and other cardiovascular risk factors in patients with T2D and T1D, the majority of these patients never achieve the goals established by guidelines issued by diabetes societies .