Roles of Insulin Resistance, Endothelial Dysfunction and Lifestyle Changes in the Development of Cardiovascular Disease in Diabetic Patients

Background: Diabetes mellitus (DM) caused 1.3 million deaths in 2010, and cardiovascular disease is the leading cause of mortality of diabetic patients. Cardiovascular disease in DM involves complex pathophysiology processes, which are promoted by many risk factors. Objective: Genetic, epigenetic, lifestyle and environmental factors are responsible for the current epidemic of diabetes and the subsequent increased risk of cardiovascular disease. Over the past years, targets focusing on the increased risk of cardiovascular events in diabetic patients have attracted significant interest. Conclusion: Within this review, the roles of insulin resistance, endothelial dysfunction and lifestyle changes in the development of cardiovascular disease in diabetic patients are discussed. Potential strategies and challenges in targeting cardiovascular risks in diabetic individuals are also considered.